Trump administration begins mailing $500 ACA refund checks to 950,000 Americans

The Trump administration has begun mailing one-time $500 refund checks to over 950,000 Affordable Care Act enrollees in 30 states. The administration frames the payments as a return of excess federal marketplace user fees accumulated under the Biden administration. However, the program is drawing scrutiny because it targets higher-income, unsubsidized enrollees rather than those hardest hit by the expiration of enhanced premium subsidies, which has caused average premiums to more than double for many families. The timing of the checks, arriving just weeks before the November midterm elections, has led critics to characterize the initiative as a politically motivated effort to attract voters.

Distribution of the refund checks

• ▪The Trump administration announced that households with more than one eligible person may receive multiple $500 Affordable Care Act refund payments
• ▪The $500 Affordable Care Act refund checks are sent automatically via paper check or direct deposit, accompanied by a letter signed by President Donald Trump
• ▪The U.S. Treasury Department began mailing one-time $500 refund checks on September 30, 2026, to more than 950,000 Affordable Care Act enrollees

Eligibility for the refund checks

• ▪Florida and Texas have the highest number of individuals receiving the $500 Affordable Care Act refund checks, followed by Wisconsin, Arizona, and Oregon
• ▪Eligibility for the $500 Affordable Care Act refund is limited to individuals who purchased 2026 health coverage through HealthCare.gov and did not receive federal premium tax credit subsidies
• ▪The White House set the 2026 ACA subsidy cutoff at approximately $62,600 for an individual and $128,600 for a family of four, meaning most ACA refund recipients earn above 400% of the federal poverty level
• ▪Eligible enrollees in 30 states using HealthCare.gov, administered by the Centers for Medicare & Medicaid Services, receive $500 refunds, while residents in 20 states and Washington, D.C., are ineligible because their states run their own health insurance exchanges

Accumulation of marketplace user fees

• ▪A KFF analysis indicates that a $1.2 billion surplus in unspent user fees had accumulated by early 2021, largely because President Donald Trump's first administration reduced spending on Affordable Care Act marketing and enrollment assistance
• ▪The Centers for Medicare & Medicaid Services set the federal exchange user fee at 2.5% of monthly premiums for 2026 and lowered it to 1.9% for 2027
• ▪President Donald Trump claimed without evidence that the Biden administration overcharged Affordable Care Act enrollees and sat on a surplus of unused federal marketplace user fees

Impact of expired premium subsidies

• ▪A March 2026 KFF survey found that approximately one in 10 Americans enrolled in Affordable Care Act plans opted out of health insurance entirely after the enhanced premium subsidies expired
• ▪The expiration of enhanced Affordable Care Act premium subsidies at the end of 2025 caused annual premium payments for subsidized enrollees keeping the same plan to more than double, from $888 to $1,904, according to KFF estimates

Debatable claims

• ▪Congress should reinstate the enhanced Affordable Care Act premium subsidies
• ▪The $500 ACA refund checks are an ineffective response to rising health insurance premiums
• ▪The Trump administration's ACA refund program unfairly excludes millions of health insurance consumers
• ▪The Trump administration's $500 ACA refund checks are a justified return of overcharged fees