Politically, handling the Affordable Care Act or not taking it on are both risky. While numerous voters do not comprehend all that the federal health law does, a few of its rules delight in broad assistance. That's particularly real of the protections for people with medical issues under the present law, insurers are disallowed from declining them for coverage or charging them more than individuals without such conditions.

Analysts on both sides anticipate concerns about health costs and health law to play a big role again in 2020. For Republicans, "the threat of not doing anything possibly leaves no port in a storm if the ACA is reversed lawfully," Rosen says. "However a more limited variation, which is what most Republicans are for, is most likely to be met with the same concerns.

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