President Donald Trump’s administration has begun sending $500 refund checks to more than 950,000 people enrolled in Affordable Care Act (ACA) health plans, along with letters bearing Trump’s signature. The payments, totaling roughly half a billion dollars, are being distributed to eligible enrollees in 30 states that use the federal HealthCare.gov marketplace. The first checks began going out on September 30.
The administration says the payments are intended to return excess fees that it claims were charged to ACA customers during the Biden administration. According to the White House, fees collected from insurers to operate the federal exchange were passed on to consumers through higher premiums, creating a surplus that the administration now says should be returned to those who paid it.
In the letter accompanying the checks, Trump says the Biden administration “overcharged” recipients for years to fund HealthCare.gov. He argues that the money belongs to working Americans rather than the government and says his administration is returning it to them. He also says he will continue working to put Americans’ interests first, lower the cost of living and reduce healthcare expenses.
Administration officials said most recipients have incomes around 400% of the federal poverty level—roughly $64,000 a year for an individual and about $132,000 for a family of four. These enrollees generally did not receive federal premium subsidies and therefore paid all or most of their insurance premiums themselves.
The refunds are going to residents of 30 states that rely on the federal exchange, including 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.
Residents of states that operate their own ACA exchanges—including California, New York and Pennsylvania—are not eligible for these payments.
Trump first announced the $500 refunds on September 10 during the Republican midterm convention in Dallas. The announcement came one day after he proposed a separate $5,000 payment to every adult American if Republicans retain control of both chambers of Congress after the November 3 midterm elections. That proposal has prompted concerns among some economists and fiscal conservatives about its potential impact on inflation and the federal debt.
The ACA marketplace currently covers millions of Americans nationwide. The Trump administration has also recently announced the removal of hundreds of thousands of enrollees it says were ineligible or involved in suspected fraud, with Vice President JD Vance saying the changes would save the program billions of dollars.
The $500 payments are not the first time a president has sent direct payments accompanied by a personal letter. Trump did so during the COVID-19 pandemic when stimulus checks were distributed, and President Joe Biden also sent signed letters with pandemic-era payments.
