There have been many options for fixing the problem discussed throughout the year, including administrative fixes and legislative tweaks. One scenario seen as likely on Capitol Hill would have OPM simply decide that the government could still subsidize insurance on the exchanges.

House Democratic leadership says the issue must be resolved.

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“The leadership has assured members that fixing this issue is a top priority,” said one Democratic leadership aide. “This issue must be fixed by administrative action in order that the flawed Grassley Amendment’s spirit is honored and all staff and members are treated the same.”

It could be politically difficult to change this provision. The provision was put in the bill in the first place on the theory that if Congress was going to make the country live under the provisions of Obamacare, the members and staff should have to as well.

The uncertainty has created a growing furor on Capitol Hill with aides young and old worried about skyrocketing health care premiums cutting deeply into their already small paychecks. Some longtime aides and members of Congress, who previously had government subsidized health care for life, are concerned that their premiums will now come out of their pension.

If their fears are borne out, the results could be twofold. Some junior staff will head for the private sector early while more seasoned aides and lawmakers could leave before the end of the year so they can continue under the old plan.

Several lawmakers said departures could run the gamut from low-level staff to legislative aides, to senior aides and lawmakers. Capitol Hill is an attractive workplace for politically ambitious college graduates, but a core of Capitol Hill aides stick around for decades, serving as institutional knowledge, and earning prized retirement packages.

OPM, which administers benefits for federal employees, is expected to rule in the coming months on how congressional health care is to be administered.

OPM did not respond to a request for comment.

More than a dozen senior aides interviewed by POLITICO about the issue declined to be named out of fear for future job prospects. The problem is most acutely felt at the staff level, where aides make between $35,000 and roughly $170,000 and budgetary problems have all but stopped pay increases and bonuses. Lawmakers have questioned leadership aides about the future of their health care.

“Between the constant uncertainty surrounding sequestration, and the likelihood aides will soon be paying for the subsidy portion of their health care coverage, congressional office budgets are being squeezed once again, and it’s causing a lot of concern amongst chiefs of staff regarding how to best handle the situation,” said one chief of staff to a senior Democratic member of the House. “Do we give raises to junior level aides so they can afford to pay for their higher health care costs, and if so, where do we find the funds to do so? Additionally, leadership has been relatively silent in terms of providing guidance to offices, which is frustrating.”

There are other ways that aides can fully avoid this problem. If they’re married, they can join their spouse’s health care plan. If they are 65, they can go on Medicare.

But the focus right now is centered on lawmakers trying to figure out how to offset potential increases in premiums.

“I know other members are doing the same thing in terms of what we can do to offset [premiums],” Rep. Tom Cole (R-Okla.) said. “You are particularly limited now because of course we’ve had the cuts in the [member office allowances] on top of this. You just don’t have a lot of options.”

Cole added, “A lot of the staff stays on largely because of the benefit levels and particularly if you’ve got people with families and it’s extraordinarily important to them … it’s just not right.”

Jennifer Haberkorn contributed to this report.