The Trump administration plans to mail $500 refund checks to nearly 1 million Affordable Care Act enrollees in 30 states, saying the Biden administration overcharged them through federal exchange fees.
Treasury Department checks, along with letters signed by President Donald Trump, will begin going out Sept. 30 to more than 950,000 people, according to an unnamed administration official cited by USA TODAY. The White House’s Sept. 10 fact sheet said checks would be sent beginning in October 2026.
According to the fact sheet, the $500-per-person refunds go to enrollees who receive no premium assistance and live in the 30 states that use the federal exchange to run their Obamacare markets.
Those states are Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Hawaii, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin and Wyoming.
The other 20 states run their own exchanges, and the federal government collected no user fees there, so their residents will not receive checks, USA TODAY reported.
Most recipients have incomes around 400% of the federal poverty level, or $64,000 for a single person and $132,000 for a family of four, the outlet said, citing the White House. Some recipients earn between 100% and 400% of the poverty level.
Healthinsurance.org describes the refund as a one-time payment for HealthCare.gov enrollees who paid full price for 2026 coverage without subsidies. Because the refund is per person, a household with more than one eligible enrollee could receive multiple checks. The site noted that most marketplace enrollees will not get one and that the payment differs from the medical loss ratio rebates some insurers send each fall.
The fact sheet asserts that user fees charged under the Biden administration were passed on to consumers as higher premiums and raised far more than the federal exchange needed, leaving a significant surplus. That claim has not been independently verified.
The refunds will draw on what the White House describes as a $500 million pool of excess fees paid by insurers, according to The Hill. Those fees have typically paid for technology support, call centers and enrollment outreach, and the Trump administration has cut outreach funding.
Trump announced the refunds Sept. 10 in a White House video released as Republicans held their midterm convention in Dallas. In it, he said enrollees paid excessive fees totaling at least $500 million and claimed the previous administration knew about the problem, studied it and kept the money, ABC News reported.
Trump also said in the video that checks would go to recipients’ home addresses and that in many cases $500 would cover the entire premium increase he blamed on Democrats, according to Time. He did not explain how he arrived at that figure.
The letter accompanying the checks tells recipients the money belongs to “hard-working Americans, not the Government,” according to a copy obtained by USA TODAY.
The checks arrive about five weeks before the November midterm election, when affordability worries pose a political risk for Republicans trying to keep control of Congress, according to USA TODAY.
Enhanced ACA subsidies expired at the end of 2025 after Trump and congressional Republicans declined to extend them, making coverage more expensive for millions, the outlet said. Premiums for some of the marketplace’s 19 million enrollees doubled or tripled, Forbes reported.
The refunds are separate from a $5,000 dividend Trump has promised every American if Republicans hold Congress after the midterms, a pledge he made in his Dallas convention speech. Several earlier payout promises, including $2,000 tariff rebate checks, have not materialized, according to Forbes.
The fact sheet also called on Congress to enact the Great Healthcare Plan, a framework Trump unveiled in January that the White House says would lower drug prices and insurance premiums.
Forbes reported at the announcement that several details were unclear: how the $500 amount was set, which enrollment period the alleged overpayments covered, the exact funding source and whether Congress must approve the checks. The Hill likewise noted it was unclear whether every recipient actually overpaid by $500.
