Politically, handling the Affordable Care Act or not taking it on are both dangerous. While lots of citizens do not understand all that the federal health law does, a few of its rules delight in broad support. That's particularly true of the protections for individuals with medical problems under the current law, insurers are disallowed from rejecting them for protection or charging them more than people without such conditions.

Experts on both sides expect concerns about health costs and health law to play a big role once again in 2020. For Republicans, "the danger of not doing anything possibly leaves no port in a storm if the ACA is overturned lawfully," Rosen says. "But a more restricted version, which is what most Republicans are for, is most likely to be met with the same concerns.

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