Pennsylvania’s insurance commissioner is urging Republican congressional leaders to retain most provisions of the Affordable Care Act.

Teresa Miller responded Thursday to lawmakers’ request for input from governors and insurance commissioners.

Miller said crucial elements of the plan include the ban on lifetime spending limits and the prohibition on excluding people with pre-existing conditions. She said reducing prescription drug costs, giving incentives to promote value over volume when accessing and paying for care and increasing transparency of health are costs to help consumers make better decisions, could help rein in healthcare spending.

Commissioner Miller also noted that more than 1.1 million people in Pennsylvania are enrolled in programs established by the ACA, many for the first time, including 670,000 residents who receive health insurance through Medicaid expansion.