BECKLEY, West Virginia ¨C For Larry Jackson, a Donald Trump-backing Republican hoping to unseat his party¡¯s incumbent in a West Virginia congressional primary next year, the fight in the U.S. Congress over Affordable Care Act subsidies is both personal and political ammunition.

Jackson, 42, says steep ACA premium hikes facing West Virginians ¡ª estimated by one think tank to average nearly 400% per enrollee next year ¡ª highlight the stakes of the expiring subsidies. It¡¯s an issue he plans to spotlight in a broader cost-of-living message for his campaign to unseat Representative Carol Miller, who has not committed to keeping them in place.

The elevation of ACA subsidies as an electoral issue among Republicans in one of the nation¡¯s most reliably conservative states a year before Americans go to the polls for midterm congressional elections underscores the issue¡¯s potential potency.

Jackson, a business owner, has relied on the ACA to provide health insurance for his family of eight. Without the enhanced subsidies, due to expire at the end of December, his monthly premium is set to quadruple to $1,850 a month.

Democrats¡¯ refusal to approve discretionary funding for federal agencies until Republicans agreed to extend the subsidies triggered the longest government shutdown in U.S. history. It ended on Wednesday without a deal to extend them.

Democrats are expected to campaign vigorously on the hikes as they seek to break the Republican grip on Congress in next November¡¯s elections.

¡°These tax credits cannot expire. It¡¯s going to hurt a lot of people in West Virginia,¡± Jackson said. ¡°We can all agree there are problems with the Affordable Care Act, but the government needs to extend these credits as they work that out.¡±

The subsidies, introduced during the COVID-19 pandemic, expanded federal assistance for Americans seeking health insurance through marketplaces created by the ACA, also known as Obamacare.

With an aging, rural population and some of the nation¡¯s highest rates of poverty and chronic illness, the state of nearly 2 million people faces among the biggest proposed premium increases in the country. The subsidies have provided a crucial lifeline to tens of thousands of West Virginians previously priced out of Obamacare coverage.

A deal struck on Sunday between Republicans and a handful of Democrats in the Senate to end the 43-day shutdown left the fate of the subsidies in limbo. While Senate leadership promised a vote on the subsidies in December, Republican leaders in the House of Representatives have not committed to a vote on them.

Of the more than 30 people reporters spoke to in West Virginia, a comfortable majority, including all Democrats and several Republicans, supported extending the subsidies until Congress could formulate a plan to make health insurance more affordable.