President Donald Trump is beginning to send $500 ACA refund checks to nearly one million Americans on Tuesday, September 30, the Trump administration confirmed, arguing that enrollees in the Affordable Care Act’s federal marketplace were overcharged under the Biden administration.
Treasury Department ACA refund checks, accompanied by letters signed by Trump personally notifying recipients, will begin going out to more than 950,000 Americans across 30 states, according to an administration official who briefed reporters.
What the ACA refund checks are
In the letter, a copy of which was viewed by USA TODAY, Trump blames the prior administration for padding health insurance costs. “For years, the Biden administration overcharged you to fund the operation of HealthCare.gov,” he writes. “That money belongs to hard-working Americans, not the Government, and now I’m returning it to you!”
The White House says the Biden administration collected user fees from health insurance companies to fund HealthCare.gov — costs that were passed on to consumers in the form of higher premiums — and that the fees collected exceeded what was actually needed to run the federal exchange. The Trump administration has accused the Biden administration of sitting on the surplus instead of returning it.
“You have paid into this flawed system, and now you are finally getting something back,” Trump’s letter continues.
Trump first announced the rebate program on September 10 in a video posted by the White House, an announcement that coincided with the Republican midterm convention in Dallas. In that video, he claimed that nearly one million Americans in 30 states had paid “excessive fees totaling at least $500 million” under the ACA’s federal exchange.
Who qualifies for the $500 refund checks
Not every ACA enrollee will receive an ACA refund check. According to the administration, eligible recipients must meet all of these requirements:
- Live in one of the 30 states that use the federally operated HealthCare.gov marketplace
- Have purchased ACA marketplace coverage through the federal exchange
- Have paid the full cost of their 2026 health plan without receiving premium tax credits or other ACA subsidies
Officials say eligible consumers do not need to apply for the ACA refund checks. The White House says qualifying recipients have already been identified and checks will be mailed automatically, with most expected to arrive in October.
Each ACA refund check payment is $500 per eligible enrollee, which means households with multiple qualifying family members could receive more than one check.
Which states are included — and which are not
The 30 qualifying states 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.
Consumers in states that run their own ACA marketplaces — such as California (Covered California) and New Jersey (Get Covered New Jersey) — are generally ineligible, since the federal government never collected HealthCare.gov user fees from their premiums.
The timing is politically charged. The checks arrive just five weeks before the November midterm elections, as high living costs and affordability remain major liabilities for Trump and congressional Republicans. The enhanced ACA premium subsidies expired at the end of 2025 — after Trump and Republicans in Congress refused to extend them — making coverage more expensive for millions of consumers this year.
Economists also note this is not the first time ACA customers have received money back. Under the law’s Medical Loss Ratio rules, insurers must spend most premiums on medical care; when they fall short, refunds are owed to enrollees. Since 2012, roughly $14.4 billion in such rebates has been issued, according to health policy analysis firm KFF.
Not the same as Trump’s $5,000 dividend
Officials stressed that the $500 ACA refund checks are separate from the controversial $5,000 dividend Trump has vowed to pay to all Americans if Republicans retain control of Congress after the midterm elections — a proposal that has drawn criticism even from some allies, with one lawmaker calling it “flagrant bribery.”
Markets, meanwhile, continue to react to the administration’s policies on other fronts — read our coverage of the Sensex and Nifty crash earlier this week for the latest on global economic pressures.
FAQs
Do I need to apply for the $500 ACA refund check?
No. The administration says qualifying recipients have already been identified and Treasury checks will be mailed automatically starting September 30, arriving mostly in October.
Why are California and New Jersey excluded?
Both states run their own ACA marketplaces (Covered California and Get Covered New Jersey), so the federal government never collected HealthCare.gov user fees from their premiums. Only HealthCare.gov states are eligible.
What did Trump say in the letter sent with the checks?
The letter, signed by Trump, says the Biden administration "overcharged" Americans to fund HealthCare.gov and that "That money belongs to hard-working Americans, not the Government, and now I'm returning it to you!"
Is this the same as the $5,000 dividend Trump promised?
No. The $500 ACA refund is separate and is being mailed now. The $5,000 payment Trump promised would only go out if Republicans retain control of Congress after the November midterm elections.
