The Trump administration has started distributing $500 refund checks to nearly 1 million Americans who purchased health insurance through the federal Affordable Care Act exchange, with payments going to eligible recipients in 30 states.
The Treasury Department began mailing the checks on Sept. 30, along with letters signed by President Donald Trump explaining the administration’s position on the refunds. More than 950,000 people are expected to receive payments, according to an administration official.
Refund Payments Target Federal ACA Exchange Users
According to USA Today, the checks are tied to user fees collected from health insurance companies that sell plans through the federal Affordable Care Act marketplace. The White House says those fees were passed on to consumers through higher premiums and that the amount collected exceeded what was needed to operate HealthCare.gov.
The administration has described the payments as a return of excess funds to consumers. In the letter sent to recipients, Trump wrote: “For years, the Biden administration overcharged you to fund the operation of HealthCare.gov,” Trump says in the letter, which was viewed by USA TODAY. “That money belongs to hard-working Americans, not the Government, and now I’m returning it to you!”
The White House has argued that the previous administration kept the surplus rather than returning it to consumers. The Biden administration’s handling of exchange user fees has been disputed by Republicans, while supporters of the ACA marketplace have pointed to the role those fees play in maintaining exchange operations.
Nearly 1 million Americans will begin receiving $500 Obamacare refund checks on Sept. 30, along with letters signed by President Donald Trump. https://t.co/qdSt53h2mj
— USA TODAY (@USATODAY) September 30, 2026
Who Will Receive The $500 Checks
The refunds are being sent to people who used federally facilitated ACA exchanges rather than states that operate their own marketplaces. The states included in the program 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.
Residents in 20 states are not included because those states run their own ACA exchanges and did not rely on federal collection of user fees.
The White House said many recipients have incomes around 400% of the federal poverty line, which is about $64,000 for an individual or $132,000 for a family of four. The group also includes some people earning between 100% and 400% of the federal poverty line.
Payments Arrive During Health Care Cost Debate
The checks are being distributed as health care affordability remains a major issue for many Americans. The timing places the payments close to the November midterm election, when health care costs are among the issues being discussed by voters and political candidates.
Trump announced the refund program on Sept. 10 in a White House video released during the Republican midterm convention in Dallas. The payments are separate from another proposal he has discussed involving a potential $5,000 dividend for Americans if Republicans maintain control of Congress after the election.
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Trump Letter Highlights Administration’s Position
The letters accompanying the checks present the payments as a direct return of money to consumers. Trump described the refunds as part of his broader health care affordability message.
“I am proud to return your money to you, and I will never stop fighting to put the American People FIRST, restore Affordability, protect your hard-earned money, and lower the Cost of Healthcare,” Trump says in the letter. “May God bless you, and may He continue to bless the United States of America.”
The refund program applies only to consumers connected to the federal exchange system and does not include people who bought coverage through state-run marketplaces. The Treasury Department is responsible for issuing the checks to eligible recipients across the 30 participating states.
