Politically, handling the Affordable Care Act or not taking it on are both dangerous. While lots of citizens do not comprehend all that the federal health law does, some of its rules enjoy broad support. That's especially true of the securities for individuals with medical issues under the existing law, insurers are disallowed from rejecting them for protection or charging them more than people without such conditions.

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

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