This story is part of CT Mirror Explains, an ongoing effort to distill our wide-ranging reporting into a "what you need to know" format and provide practical information to our readers.

COVID-era financial assistance for ObamaCare health plans, known as enhanced premium tax credits, are all but guaranteed to lapse at the end of the year, with Congress set to leave town this week without addressing them. 

After a failed vote last week to extend the subsidies for three years, Gov. Ned Lamont announced that Connecticut will foot the bill to maintain financial assistance for some Connecticut residents. However, there are residents who are set to lose some or all aid.

Here’s what to know about who could be impacted, Connecticut’s plans and the chances of the subsidies getting extended.

Who is going to be impacted? 

About 90% of Access Health CT enrollees — or 143,000 Connecticut residents — receive some sort of subsidy to help defray the cost of premiums. With the subsidies expiring, those residents were set to lose some or all of the financial assistance they receive. 

Access Health CT is the official state health insurance marketplace created to meet the requirements of the Affordable Care Act. 

The lapse would mean individual enrollees could see their premiums rise by an average of $2,380 per year for an individual and $10,000 annually for a family of four. Connecticut would have to spend $295 million per year to maintain the current level of financial assistance provided by the expiring federal subsidies.

What is Connecticut going to do?

Last week, Lamont pledged $70 million in state funding to keep premiums stable for the most financially vulnerable families set to get hit by the expiring tax credits, but hinted that more help might be on the way. On Wednesday, the governor increased the investment to nearly $115 million through June 2027. 

The plan includes $64.1 million to maintain CoveredCT through June 2027, according to a letter the governor penned to legislators informing them of the expenditures. CoveredCT currently uses federal subsidies to provide no-cost plans to low-income families that earn slightly too much to qualify for Medicaid. 

Another roughly $50.8 million will go toward replacing the subsidies entirely for Connecticut residents who aren’t in CoveredCT, but earn between 100% and 200% of the Federal Poverty Level. It will also cover half of the current financial assistance for people earning between 400% and 500% of FPL, who are set to lose all financial assistance once the federal subsidies expire. 

However, unlike the CoveredCT funding, the $50.8 million only covers subsidies through the end of 2026.

In addition to the $115 million in direct subsidy support to CT residents, the state will pay community health centers $5 million through June 2027 “to help promote access to primary and preventive care for those individuals with incomes below 100% of the FPL at risk of losing coverage due to elimination of all federal health plan subsidies,” according to the governor’s letter.

Anyone who already signed up for a plan and qualifies for state assistance will have their premiums adjusted, according to Access Health CEO James Michel. 

Due to recent outage issues with Access Health CT’s website, the agency has extended the enrollment deadline for plans beginning in the new year to Dec. 20, Michel confirmed.  

The funding for subsidy replacement will come from $500 million in state reserves designated during last month’s special session, which was intended to potentially backfill federal cuts to nutrition, health care, heating assistance and other human service programs until the next General Assembly session starts Feb. 4. 

What’s going on with Congress right now?

The imminent expiration set off a last-minute scramble on Capitol Hill to see if the House would take it up. Democrats’ three-year extension failed to get through the Senate last week. 

House Republicans ultimately put a bill on the floor that would implement various health care reforms but didn’t include any extension of the subsidies. The bill passed along party lines on Wednesday, but is likely to get blocked when it reaches the Republican-controlled Senate. 

Republicans have opposed the Affordable Care Act since its passage in 2010, but they have struggled to unify around a replacement plan. Most Republicans view the tax credits as a costly measure that was supposed to be temporary when it was created in a pandemic relief bill. 

House Speaker Mike Johnson, R-La., has been resistant to putting a subsidies extension on the floor. That rankled a bloc of moderate Republicans, who came up short in their push for a vote after tense negotiations with Johnson. 

“Many of them did want to vote on this Obamacare, COVID-era subsidy the Democrats created. We looked for a way to try to allow for that pressure release valve and it just was not to be,” Johnson said Tuesday. 

The only other avenue available is through a procedural tool called a discharge petition. If lawmakers can collect 218 signatures, it forces a vote on the House floor. 

There are two bipartisan petitions that extend the subsidies, but for a shorter timeframe than sought by Democrats and with changes to eligibility. U.S. Rep. Joe Courtney, D-2nd District, is the only member of Connecticut’s delegation to sign onto both. But the two measures are short of the needed signatures. 

Is there any chance the subsidies will get extended?

Democrats’ petition for a three-year extension was signed by everyone in their party, meaning they only needed four Republicans to join. On Wednesday, they secured the necessary signatures from the Republicans to force a vote to renew the tax credits. 

This leaves at least one avenue through which the subsidies could get extended in January. But the motion won’t get a vote until the new year based on House rules. And if it reaches the Senate, a three-year extension is expected to get blocked again.