President Donald Trump announced on Thursday, September 10, 2026, that his administration will send $500 refund checks to nearly 1 million participants of the Affordable Care Act (ACA). The White House stated the payments are intended for individuals in 30 states who purchase health insurance through the federal marketplace and do not receive financial assistance or subsidies. According to the administration, these payments serve as a refund for exchange "user fees" that it claims were collected in excess during the Biden administration.
The announcement follows the expiration of coverage subsidies previously allowed by Congress, which led to higher premiums for many enrollees. According to KFF, a poll conducted in early 2026 found that 80% of returning ACA participants reported higher costs for premiums, deductibles, or coinsurance and copays compared to the previous year. Larry Levitt of KFF stated that these payments would primarily benefit middle-income individuals who lost subsidies and are now paying significantly more for coverage.
The White House indicated that the $500 checks are expected to be mailed directly to eligible households starting in October. President Trump described the move as returning money to people who were "wrongly ripped off" by excessive fees totaling at least $500 million. The administration also tied the initiative to a broader goal of lowering healthcare costs and called for Congress to pass the "Great Health Care Plan," which proposes changes to prescription drug pricing and insurance rate transparency.
Eligible enrollees will notice the change in their mailbox starting in October 2026, just weeks before the November midterm elections. This direct cash injection coincides with other fiscal proposals from the administration, including a separate pledge to send a $5,000 dividend to every U.S. adult if Republicans maintain control of Congress. The administration claims the $500 refunds are possible because marketplace fees collected under the previous administration created a surplus that exceeded the costs required to operate the insurance exchange.
The action sets a precedent for using marketplace fee surpluses for direct consumer refunds rather than reinvesting them into exchange operations or lowering future premiums, though the White House has not yet clarified if future fees will be permanently reduced. While the One Big Beautiful Bill Act (OBBA) contains the administration's larger planned changes to the health law, those measures are expected to take several years to implement fully. The next steps for this program involve the mailing of the physical checks through the fall, while the broader health care proposal awaits potential legislative action in Congress.