Politically, taking on the Affordable Care Act or not taking it on are both dangerous. While many citizens do not understand all that the federal health law does, some of its rules delight in broad assistance. That's especially real of the protections for individuals with medical issues under the existing law, insurance providers are disallowed from declining them for coverage or charging them more than individuals without such conditions.

Analysts on both sides expect concerns about health expenses and health law to play a big role once again in 2020. For Republicans, "the risk of doing nothing possibly leaves no port in a storm if the ACA is reversed legally," Rosen states. "But a more minimal variation, which is what most Republicans are for, is likely to be satisfied with the same issues.

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