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Politically, taking on the Affordable Care Act or not taking it on are both dangerous. While many voters do not understand all that the federal health law does, a few of its rules take pleasure in broad support. That's particularly real of the defenses for individuals with medical problems under the existing law, insurance companies are disallowed from declining them for protection or charging them more than individuals without such conditions.

Experts on both sides anticipate issues about health expenses and health law to play a big role once again in 2020. For Republicans, "the threat of doing nothing possibly leaves no port in a storm if the ACA is overturned lawfully," Rosen says. "But a more limited variation, which is what most Republicans are for, is likely to be consulted with the same concerns.

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