Politically, handling the Affordable Care Act or not taking it on are both dangerous. While lots of voters do not understand all that the federal health law does, some of its rules enjoy broad support. That's especially real of the securities for people with medical problems under the present law, insurance providers are disallowed from rejecting them for protection or charging them more than people without such conditions.

Analysts on both sides expect issues about health costs and health law to play a large role again in 2020. For Republicans, "the risk of not doing anything possibly leaves no port in a storm if the ACA is overturned lawfully," Rosen states. "But a more minimal variation, which is what most Republicans are for, is likely to be consulted with the same issues.

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