They have to either renew the STA or get their license modified for the lower power.
If they operate at less than authorized power without STA for more than a year, they're risking losing their license altogether.
An Act of Congress requires the FCC to revoke the license of a station that remains off the air for more than a year, and the Commission has ruled that operation with unauthorized facilities counts as not operating at all.
If they get the license modified, then other stations can apply for power increases and/or changes to their antenna system. (changes that would have interfered with your station if you were still operating at full power) Or, applications can be filed for completely new stations that would have interfered with your station.
Of course, once those changes are applied for, you can't go back to your old higher power as you'd interfere with the *new* service.
Even if nobody else applies for new service, there's a racheting rule (which Scott Fybush is going to have to explain) which will require your new facilities to cause less interference than the old ones.
In other words, unless you're able to keep your STA valid until you can rebuild the original facilities, you are indeed going to lose authorization to someday return to your original full power.