What Republicans such as Trump or DeSantis might try to do with the ACA remains to be seen. A repeal of the law could have far-reaching effects.

"About 55 million Americans would suddenly be uninsured, and insurance companies would once again be allowed to deny health insurance, or charge substantially higher premiums, to anyone with a pre-existing condition," said Gerald Kominski, senior fellow at the UCLA Center for Health Policy Research. "This may be the world ideologues want us to live in, but it would be a public health disaster."