Trump says $500 checks will go to 1 million ACA enrollees starting in October

Nearly 1 million people who buy their own health coverage through the federal insurance marketplace would receive one-time $500 payments beginning in October, the White House said Sept. 10 in announcing a program it calls the Working Families Obamacare Refunds.

The checks would go to enrollees in the 30 states that run coverage through HealthCare.gov and who receive no premium assistance under the Patient Protection and Affordable Care Act.

A White House official told Reuters the money would go primarily to people earning more than 400% of the federal poverty level, who do not qualify for subsidies, along with people between 100% and 400% of poverty who did not receive them. Recipients have already been identified, the official said.

Fees collected under former President Joe Biden ran “far in excess of what was needed to run the exchange,” the White House said in the fact sheet, and reached consumers in the form of higher premiums.

The document promises to return hundreds of millions of dollars without sizing the surplus itself or saying whether fees and premiums will fall. Trump accused the Biden administration of mismanaging Affordable Care Act funds without offering evidence, the Associated Press reported.

The administration is “giving the money back to the people who were wrongly ripped off,” President Donald Trump said in a video posted to the White House account on X, formerly Twitter.

How the $500 amount was calculated, which enrollment years the disputed fees cover and whether disbursing the money requires congressional approval all remain unexplained.

The Centers for Medicare and Medicaid Services and a White House official declined to comment to the AP, pointing back to the fact sheet. The Department of Health and Human Services and the White House did not immediately answer questions from Reuters.

Several previous promises of direct payments to Americans have not been paid out, including $2,000 tariff rebates and $5,000 dividend checks tied to federal cost cutting. Congress rejected a proposal to deposit $1,000 to $1,500 into Americans’ health savings accounts after the enhanced Affordable Care Act subsidies expired.

Where the money comes from

The surplus may not date to the Biden administration at all. Cynthia Cox, vice president and director of the ACA program at KFF, told the AP that Trump’s first administration collected more in insurer user fees than it spent, leaving an estimated $1 billion unspent by KFF’s analysis.

The plan “does not appear to be helping the people who lost coverage” because they could not afford to keep buying insurance, Cox said.

Brad Woodhouse, a Democratic strategist and executive director of Protect Our Care, called the plan a “gimmick” and “an absolute joke” in a statement, saying monthly premiums have climbed by hundreds or thousands of dollars since the tax credits lapsed.

Officials described the source as a $500 million pool of excess fees sitting in government accounts, Axios reported.

“That money was over-collected and just sitting there,” one official told the outlet. The fact sheet names no figure. At $500 apiece, payments to 1 million enrollees would come to $500 million.

That same balance drew a fight in 2023, when the Biden administration proposed spending it on no-cost contraception for enrollees whose plans did not cover it. Congressional Republicans objected that the fees were dedicated to running the exchanges and that CMS lacked the authority to redirect them, and the proposal was withdrawn, according to Axios.

Rising premiums and shrinking coverage

CMS reported that 23.1 million people enrolled in exchange coverage for 2026. Roughly 19 million now hold marketplace coverage, according to the AP. Premiums doubled or tripled for many enrollees after Congress allowed the enhanced COVID-19-era tax credits to lapse at the end of 2025, and millions responded by downgrading their plans or leaving the exchanges entirely.

CMS finalized marketplace rules for 2027 in May that let insurers sell catastrophic plans with terms of up to 10 consecutive years and widen the hardship exemptions that allow people to buy them.

The same rule cut the federal exchange user fee, the charge at the center of the rebate announcement, to 1.9% of premiums from 2.5%, a reduction CMS said would put downward pressure on 2027 premiums.

The payments are also distinct from the medical loss ratio rebates insurers have issued since 2012, which are triggered when a carrier spends less than 80% of premium dollars on care and quality improvement.

Trump announced the plan a day after telling a Republican midterm convention in Dallas that every American adult would receive $5,000 if the party holds the House and Senate.

A White House official told Reuters the two programs are unrelated. The checks would land in mailboxes and bank accounts in the weeks before the Nov. 3 election.