About 400,000 Californians could find it difficult to afford health coverage from their Obamacare plans next month as subsidies expire and premiums skyrocket.

And chances are shaky Congress will provide much help before Jan. 1, even as an unpredictable election year looms.

Lawmakers are scheduled to be in session this week and next before leaving for the year.

The Senate is expected to vote Thursday on a Democratic plan to extend the subsidies for three years. In the House, bipartisan groups are pushing plans that would provide a two-year extension.

There are huge obstacles to getting anything done. The Senate plan is expected to fail, since it needs 60 votes and Democrats control 47. Republican leaders have been cool to any extension, and senators Monday were circulating alternatives. They’re expected to be discussed in party caucus meetings Tuesday.

The House proposal so far has not won support from key leaders in that chamber.

Republicans and Obamacare

Affected are policies people can buy under the Affordable Care Act, or Obamacare. What’s expiring at the end of the year are the credits enacted in 2021, aimed at helping people weather the COVID-triggered economic crisis.

Repealing Obamacare has long been a staple of official Republican health care policy, making it difficult to extend the subsidies.

Senate Majority Whip John Barrasso, R-Wyoming, a physician who has been a strong Obamacare critic, reiterated his view last week.

“The Biden COVID bonuses are an expensive, fraud-ridden failure, and the Democrats want to extend them for another three years,” he said. “It will not help the American people.”

But having premiums spike could be a huge political liability next year, and a lot of vulnerable Republicans are trying to prevent such increases.

“I’m certainly open to negotiating all aspects of this. What is not acceptable is doing nothing,” said Rep. Kevin Kiley, R-Roseville, whose current congressional district has been carved into six pieces to give Democrats better chances of winning. Kiley is supporting bipartisan plans to keep the subsidies for two years.

The compromise plan

Thirty-five House members from both parties are pushing a two-year extension bill.

They would limit the full credit in 2026 to those with incomes below 600% of the federal poverty line, or currently $192,900 for a family of four. The credit would then be phased out for higher incomes.

Those credits would continue in 2027, but Congress would consider several reforms to the system, including a requirement for hospitals to be more transparent in disclosing fees and costs.

Supporters include Kiley and Reps. Jim Costa, D-Fresno, Adam Gray, D-Merced, David Valadao, R-Hanford, Jimmy Panetta, D-Carmel Valley, Scott Peters, D-San Diego and Sam Liccardo, D-San Jose.

Kiley and Liccardo have pushed another alternative. Their Fix It Plan would extend the subsidies for two years. It would get tough on overpayments to the Medicare Advantage program, which helps insure seniors, and on some insurance broker practices.

How much will it cost?

Currently, consumers can choose from several ACA plans.

Gold and platinum plans generally have smaller out-of-pocket costs but premiums are higher. Silver plans are a moderate priced alternative.

The nonpartisan Urban Institute estimates that about 400,000 California families will lose the enhanced subsidies unless Congress acts.

Covered California, which manages the state’s marketplace system, estimates that premiums on average would go up 97% next year without the subsidies.

That’s a smaller percentage than the increases nationally, largely because of the state’s relatively younger and healthier population. Californians also benefit from an annual rate review process and a minimum of two carrier choices for all enrollees.

As people sign up for coverage this month, “We’re encouraging consumers to shop and compare and try to find a plan that best fits their budget,” said Jagdip Dhillon, Covered California spokesman.

He said about half of Covered California’s current enrollees qualify for health insurance costing $10 or less per month in 2026, and about one-fourth could buy a silver plan for that same price.

But for others, prices could skyrocket.

KFF, a nonpartisan health care research organization, estimated that in the Sacramento area, a 40-year-old with a $31,000 income, who paid $58 a month for the silver plan, would see their payment increase to $153.

A 60-year-old couple with an $82,000 income now pays $581 a month. Their cost would go to $2,551.

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