Politically, handling the Affordable Care Act or not taking it on are both risky. While lots of voters don't comprehend all that the federal health law does, some of its guidelines delight in broad support. That's especially true of the protections for people with medical issues under the current law, insurance companies are barred from declining them for coverage or charging them more than people without such conditions.

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

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