WATCH: The House reconvenes as Congress grapples with what to do about shoring up the ACA

WASHINGTON (AP) — 52-year-old Dinam Bigney got deep into debt and had to get a roommate this year, in part because of health insurance premiums that cost him nearly $900 a month.

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Next year, that monthly fee will rise by $200, a large enough increase that the program director at Aldi, Va., has given up on finding cheaper coverage.

Read more: 4 Tips for Navigating Higher ACA Health Care Premiums

“I won’t be able to pay that amount, because I’ve already depleted any savings I have now,” he said. “The emergency fund is still depleting — that’s the scary part.”

Bigny is among many Americans who rely on health insurance plans in the Affordable Care Act marketplace and are already struggling with the rising cost of health care, according to a new survey by the health care research nonprofit KFF.

Most of the more than 1,300 enrollees surveyed in early November say they expect their health costs to take a hit next year if Congress does not extend expiring coronavirus-era tax credits that help more than 90% of enrollees pay their health insurance premiums, per KFF. The prospect of an extension seems increasingly unlikely.

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Enhanced tax breaks set to expire at the end of this year have been at the heart of recent tensions in Congress, with Democrats calling for their direct extension and several Republican lawmakers strongly opposing the idea. Their inability to agree on a path forward led to a record 43-day government shutdown earlier this fall.

President Donald Trump and some Republicans in Congress have circulated proposals in recent weeks to provide a short-term extension or reform of the Affordable Care Act, but no plan has emerged as a clear winner. Meanwhile, the opportunity for Americans to shop for next year’s plans is well underway, with less than a month left until the subsidies expire.

The KFF poll reveals that market enrollees — most of whom say they will be directly affected by the end of subsidies — overwhelmingly support an extension. The poll found that this group is more likely than Democrats to blame Trump and Republicans in Congress if the tax breaks are left to expire.

Registrants already find it difficult to afford health expenses

The end of the tax credits — which a separate KFF analysis found would more than double monthly payments for regular subsidized enrollees — comes at a time when Americans are already struggling with rising health expenses, the poll showed.

About 6 in 10 Affordable Care Act enrollees find it “somewhat” or “very” difficult to afford out-of-pocket medical care costs, such as deductibles and copayments. This exceeds the nearly half of enrollees who have difficulty affording health insurance premiums. Most also say they can’t afford a $300-a-year increase in their health insurance costs without significantly hurting their family’s finances.

The number of Americans subject to the Affordable Care Act includes some high-income entrepreneurs and small business owners, but the bulk of enrollees are low-income and thus vulnerable to small increases in health costs, said Cynthia Cox, a KFF vice president who leads the organization’s ACA research.

“These are often people who are living paycheck to paycheck, and they also have fluctuating or unpredictable income,” she said. “The increases that a lot of them are facing are going to be a bit of a financial hardship for them.”

Most enrollees see cost increases on the horizon

Just over half of those enrolled in the Affordable Care Act’s marketplace believe their health insurance costs will increase “much more than usual” in the next year, according to the poll. About 4 in 10 expect increases to be “slightly more than usual” or “about the same as usual.”

Larry Griffin, a 56-year-old investment banker and financial advisor in Paso Robles, California, already pays $920 a month for his gold-level health plan through the state’s insurance marketplace. He says the price will rise to about $1,400 a month in the next year — along with jumps in co-payments and an annual maximum for out-of-pocket expenses.

He worries that the increases will impact his ability to save money for his upcoming retirement, but with his left leg recently amputated below the knee, as well as other health issues, he said he can’t risk dropping out of health insurance or having his plan downgraded.

Griffin is among nearly three-quarters of marketplace enrollees who say health insurance is “very important” to their ability to access the health care they need.

“I’m not going to say I can’t manage it, I can, but it’s just another one of those things,” he said. “Here it is, you know, ticking 5,000 against me after all the other things I’ve had to deal with.”

Patricia Roberts, 52, a full-time caregiver for her daughter in Auburn, Alabama, expects her monthly health insurance premiums to rise from about $800 a month to $1,100 a month next year, costs she can afford. But her friends across the border in Georgia are looking to double their monthly fees next year.

“I don’t know how people are going to survive, as it’s already a struggle to pay for food and all the other things,” Roberts said.

Support for the extension extends across political parties

Allowing the enhanced tax credits to expire would be very unpopular with current filers in the market, the survey shows.

Support for continuing tax breaks extends across party lines. Nearly all Democrats and about 8 in 10 independents enrolled in marketplace plans say the credits should be extended, as do about 7 in 10 Republicans. Support is similarly high among Republicans and Republican-leaning independents who support the MAGA movement, and those who do not.

Yvette LeGaire, 56, a Republican in Chicago, said that although her income is too high to qualify for the enhanced tax credits, she supports temporarily extending them with additional fraud protections to give low-income filers more time to consider their options.

Among those who think Congress should extend the appropriations, about 4 in 10 say Trump would deserve “most of the blame” if he allowed them to expire, and nearly a third say congressional Republicans. Democrats in Congress are unlikely to take the blame: only 23% of those registered say they deserve the bulk of the responsibility.

In Virginia, Bigney said the blame should be divided between Democrats and Republicans. But he hopes they can reach a compromise and perhaps a temporary extension in the coming weeks.

“They have to sit down and really look at what is best for the American people overall,” he said.

Swenson reported from New York.