WASHINGTON — Fifty-two-year-old Dinam Bigny sank into debt and had to get a roommate this year, in part because of health insurance premiums that cost him nearly $900 per month.

Next year, those monthly fees will rise by $200 — a significant enough increase that the program manager in Aldie, Virginia, has resigned himself to finding cheaper coverage.

“I won’t be able to pay it, because I really drained out any savings that I have right now,” he said. “Emergency fund is still draining out — that’s the scary part.”

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

Most of the more than 1,300 enrollees surveyed in early November say they anticipate that their health costs will be impacted next year if Congress doesn’t extend expiring COVID-era tax credits that help more than 90% of enrollees pay for health insurance premiums, per KFF. The possibility of an extension looks increasingly unlikely.

The enhanced premium tax credits set to expire at the end of this year have been at the center of recent tensions in Congress, with Democrats calling for a straight extension and several Republican lawmakers vehemently opposed to the idea. Their inability to agree on a path forward fueled a record 43-day government shutdown earlier this fall.

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

KFF’s poll reveals that marketplace enrollees — most of whom say they would be directly impacted by the subsidies expiring — overwhelmingly support an extension. The survey found this group is more likely to blame Trump and Republicans in Congress than Democrats if the tax credits are left to expire.

The expiration of the tax credits — which a separate KFF analysis found will more than double monthly payments for the average subsidized enrollee — comes as Americans are already overwhelmed by high health expenses, the poll shows.

About 6 in 10 Affordable Care Act enrollees find it “somewhat” or “very” difficult to afford out-of-pocket costs for medical care, such as deductibles and copays. That exceeds the roughly half of enrollees who find it challenging to afford health insurance premiums. Most also say they could not afford a $300 per year increase in their health insurance costs without significantly disrupting their household finances.

Cynthia Cox, a vice president of KFF who leads the organization’s ACA research, said the population of Americans on Affordable Care Act health insurance includes some high-earning entrepreneurs and small business owners, but the bulk of enrollees are lower-income and therefore vulnerable to even small increases in health costs.

“These are often going to be people who are living paycheck to paycheck, who have volatile or unpredictable incomes as well,” she said. “Increases that many of them are facing are going to be some sort of financial hardship for them.”

Slightly more than half of Affordable Care Act marketplace enrollees believe their health insurance costs will increase “a lot more than usual” next year, according to the poll. About another 4 in 10 anticipate increases that will be “a little more than usual” or “about the same as usual.”

Larry Griffin, a 56-year-old investment banker and financial adviser in Paso Robles, California, already pays $920 a month for his gold-level health plan through the state’s insurance marketplace. He says that price will go up to about $1,400 a month next year — alongside jumps in copays and his annual out-of-pocket maximum.

He’s concerned the increases will affect his ability to save money for his upcoming retirement, but with the recent amputation of his left leg below the knee, as well as other health issues, he said he can’t risk going off health insurance or downgrading his plan.