Despite that, those opposed to it either because of its flaws or because of ideology simply couldn't agree on how to repeal and replace it—the Republicans' and Trump administration's chief mission right after the inauguration.

But after Senator John McCain's tiebreaking vote against killing the ACA, all of a sudden it seems that everyone from consultants to legislators is suddenly talking about ways to improve the existing law or ways to better the way it functions, rather than tossing the baby out with the bath water.

Everyone, that is, except the Trump administration itself, which has just announced a slashed budget for federal funds intended to help people sign up for ACA coverage.

Consultantancy Oliver Wyman released a paper just days before hearings before the Senate Health, Education, Labor and Pensions Committee are supposed to begin on ways to stabilize insurance markets in the short term.

And a bipartisan group of governors has proposed strategies to strengthen the ACA marketplaces to keep the system functioning both short and long term.

The most recent entry into the field of suggestions is a group of five somewhat "controversial" proposals that NPR says "are starting to generate buzz in policy circles." Let's take a look at them:

 5. Let people use HSA contributions to pay health insurance premiums.

Republicans are big on health savings accounts, so this one might actually gain traction—especially since it was part of one of the provisions in the failed Senate GOP health care bill that went down to defeat in July.

Basically, the idea is to allow people to use money from their tax-preferred HSAs to pay the premiums on insurance policies. HSAs, which are linked to high-deductible insurance plans, are used by consumers to pay out-of-pocket medical expenses; money stashed in these accounts, as well as any earnings on the funds, are not taxable.

But at present, while there are exceptions, people aren't allowed to use that money to pay premiums.

Changing the rules to allow premium payments would help those who buy their own insurance but make too much to qualify for federal premium subsidies and can't deduct premiums from their taxes because they're not technically self-employed. They're also among those who have been disproportionately hurt by rising premiums in the individual market since the ACA fully took effect.

4. Require insurers who participate in other government programs to offer marketplace coverage.

One problem with ACA marketplaces is a lack of competition among insurers, especially in rural areas. This year a third of counties have only a single insurer in their marketplaces, and that number looks sure to rise in 2018.

To stimulate competition, several analysts have suggested making access to participation in other government programs conditional on a willingness to offer individual ACA policies too.

Among the suggestions are tying the offering of coverage to federal workers to exchange participation and making insurers offering profitable Medicare Advantage plans also provide individual exchange coverage.

3. Get younger adults off their parents' insurance and back into the individual market.

While letting young adults up to age 26 stay on their parents' health coverage is one of the most popular ACA features, it's just those people who really need to be on the individual marketplace, since they're young and healthy and their presence on the exchanges would drive down the cost of coverage for everyone.

But that is one ACA provision unlikely to be touched, with 3 million young people already covered that way. Still, according to Joseph Antos at the conservative-leaning American Enterprise Institute, they're one reason the exchanges are in trouble.

"Frankly, it was really stupid" to keep those young people out of the individual market," Antos says in the report, since it keeps out of the risk pool people who are "young, healthy and whose parents will pay their premiums." Their absence from the marketplace means the concentration of the young and healthy is only around 28 percent, when it needs to be higher—say, around 40 percent.

2. Allow people to "buy in" to Medicaid.

Medicaid buy-ins already exist, the report says, pointing to the 2005 Family Opportunity Act, which allows families earning up to three times the poverty level to purchase Medicaid coverage for their disabled children who aren't otherwise eligible. Medicaid has generally provided better benefits for those with disabilities than private health insurance.

And this may be an idea whose time is coming; although earlier this year Brian Sandoval, Republican governor of Nevada, vetoed a bill that would have allowed Nevada residents to buy Medicaid coverage through the state's insurance exchange, Senator Brian Schatz, D-Hawaii, is pushing for a federal Medicaid buy-in plan.

Schatz's plan would give states the option to let people making more than the current Medicaid eligibility thresholds pay a premium to join the program. It would allow those who qualify for federal tax credits to use them to pay the premiums.

It would also raise Medicaid reimbursements to doctors, hospitals and other health care providers to the same level Medicaid pays them to treat Medicare patients. Low Medicaid payment rates have discouraged many doctors, specialists in particular, from accepting Medicaid patients.

1. Allow people into Medicare starting at age 55.

The idea isn't new, but it certainly has merit. Allowing younger people to buy in to Medicare could lower premiums for everyone on the program, since presumably younger participants would be healthier and require less—and less expensive—care.

That's the intent of a Medicare buy-in bill that was introduced earlier this month by Sen. Debbie Stabenow, D-Mich., and seven other Democratic senators.

Their bill would allow customers ages 55–64 in the ACA market to buy Medicare coverage instead, but it would also let them use ACA tax credits if they are eligible for those. The cost of such policies has not been worked out.

Needless to say, while Democrats favor such a plan—since it comes closer to a Medicare-for-all plan—Republicans are opposed for the same reason.

But as the muttering is getting louder, legislators may be getting closer to considering one or more of these strategies. Only time will tell.