Politically, handling the Affordable Care Act or not taking it on are both risky. While numerous voters do not comprehend all that the federal health law does, some of its guidelines delight in broad support. That's particularly real of the securities for individuals with medical issues under the existing law, insurance companies are disallowed from rejecting them for protection or charging them more than individuals without such conditions.

Analysts on both sides anticipate concerns about health costs and health law to play a big role once again in 2020. For Republicans, "the threat of not doing anything possibly leaves no port in a storm if the ACA is overturned legally," Rosen says. "However a more limited version, which is what most Republicans are for, is likely to be met the exact same issues.

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