Politically, taking on the Affordable Care Act or not taking it on are both risky. While lots of citizens don't comprehend all that the federal health law does, some of its rules delight in broad assistance. That's particularly real of the defenses for people with medical issues under the existing law, insurance companies are barred from rejecting them for protection or charging them more than individuals without such conditions.

Analysts on both sides expect concerns about health costs and health law to play a large role once again in 2020. For Republicans, "the danger of not doing anything potentially leaves no port in a storm if the ACA is overturned legally," Rosen states. "But a more limited version, which is what most Republicans are for, is most likely to be consulted with the exact same concerns.

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