[smueller1234]

They make it easier, but just at a source code level. They're not a real (and certainly not full) abstraction. An example that'll be making it obvious: if you replace the underlying type with a floating point type, the semantics would change dramatically, fully visible to the user code.

With larger types that otherwise have similar semantics, you can still have breakage. A straightforward one would be padding in structs. Another one is that a lot of use cases convert pointers to integers and back, so if you change the underlying representation, that's guaranteed to break. Whether that's a good or not is another question, but it's certainly not uncommon.

(Edit: sibling comments make the same point much more succinctly: ABI compatibility!)