WASHINGTON —

Millions of Americans signing up for individual health insurance plans are facing higher out-of-pocket costs.

Open enrollment for Affordable Care Act marketplaces started this weekend, but Congress is still debating a plan to lower premiums. It's one of the issues holding up a deal to end the government shutdown.

Democrats want to extend enhanced tax credits that have decreased costs, but are due to expire at the end of this year without further action. Republicans want to revisit the conversation after reopening the government.

"This is a very stressful situation for the 22 million people who get a tax credit right now and are expecting that, next year, they'll either get less financial help or maybe no financial help at all," said Cynthia Cox, vice president of KFF, a he

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