Politically, handling the Affordable Care Act or not taking it on are both risky. While lots of citizens do not comprehend all that the federal health law does, a few of its rules delight in broad support. That's especially true of the defenses for people with medical issues under the present law, insurance companies are disallowed from rejecting them for coverage or charging them more than people without such conditions.

Analysts on both sides anticipate concerns about health costs and health law to play a large role once again in 2020. For Republicans, "the threat of doing absolutely nothing possibly leaves no port in a storm if the ACA is reversed legally," Rosen says. "But a more minimal variation, which is what most Republicans are for, is most likely to be consulted with the same concerns.

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