Politically, handling the Affordable Care Act or not taking it on are both risky. While numerous voters don't understand all that the federal health law does, some of its rules enjoy broad support. That's especially true of the defenses for individuals with medical issues under the current law, insurance companies are barred from declining them for protection or charging them more than people without such conditions.

Experts on both sides expect issues about health costs and health law to play a large role once again in 2020. For Republicans, "the danger of doing nothing possibly leaves no port in a storm if the ACA is reversed lawfully," Rosen states. "However a more restricted version, which is what most Republicans are for, is most likely to be consulted with the exact same issues.

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