President Donald Trump's administration began sending $500 checks to more than 950,000 Americans across 30 states on September 30, refunding money the White House says consumers were overcharged through the Affordable Care Act's federal health insurance exchange.
The Treasury Department checks are accompanied by letters signed by Trump and are being distributed five weeks before the November midterm elections, as affordability remains a major issue for voters and Republicans seek to retain control of Congress, as USA Today reports.
"For years, the Biden administration overcharged you to fund the operation of HealthCare.gov," Trump says in the letter. "That money belongs to hard-working Americans, not the Government, and now I'm returning it to you!"
The administration first announced the refunds on September 10, saying it would return about $500 million collected through fees assessed on insurers participating in the federal ACA marketplace. The White House argues those fees, which are ultimately reflected in premiums, generated more money than was needed to operate HealthCare.gov.
Such user fees have been collected under multiple administrations, including Trump's first. KFF, a health policy nonprofit, estimated near the end of his first term that the federal government had accumulated more than $1 billion in unspent user fees, USA Today reported.
The refunds come after enhanced ACA subsidies expired at the end of 2025 after Trump and congressional Republicans declined to extend them, increasing insurance costs for millions of consumers.
Recipients are concentrated in 30 states that rely entirely or partly on the federally administered ACA exchange. The other 20 states operate their own exchanges and are not included because the federal government did not collect their user fees.
Most recipients earn about 400% of the federal poverty level — approximately $64,000 for an individual or $132,000 for a family of four — although some people earning between 100% and 400% of the poverty level also qualify, according to the White House.
The checks are separate from Trump's proposal to distribute $5,000 dividends to American adults if Republicans retain control of Congress after the midterms. Unlike that proposal, the ACA refunds are already being distributed.
"You have paid into this flawed System, and now you are finally getting something back," Trump wrote in the letter accompanying the checks.
