Trump is sending $500 refund checks to nearly a million Americans. Here’s who gets them

The Affordable Care Act $500 refund checks are in the mail to nearly a million Americans, along with a letter from President Donald Trump touting his healthcare accomplishments and casting blame on his predecessor.

The Treasury Department began sending the one-time payments on Wednesday to more than 950,000 Obamacare enrollees in 30 states that use the federal exchange, healthcare.gov .

They will be funded through unspent user fees paid by insurers. Trump has said that these Obamacare policyholders were “wrongly overcharged” during the Biden administration – a claim that some experts dispute.

The rebates are arriving a little more than a month before the midterm elections, and Republicans are fighting to maintain their control of Congress. Healthcare costs are a main concern of voters, especially as premiums and out-of-pocket costs rise for many folks.

In his letter, Trump wrote, “For years, the Biden Administration overcharged you to fund the operation of HealthCare.gov . That money belongs to hard-working Americans, not the Government, and now, I am returning it to you!”

“You have paid into this flawed System, and now you are finally getting something back,” he wrote, listing his efforts to root out fraud , reduce drug prices and boost spending on rural healthcare.

The refunds are going to policyholders who did not receive federal premium subsidies to buy Affordable Care Act coverage. (The vast majority of Obamacare enrollees are subsidized.) Most of the recipients are middle-class Americans who earn too much to receive subsidies this year – more than $62,600 as an individual or $128,600 for a family of four, according to the White House.

Trump announced he would provide the rebates last month, the day after he promised to send $5,000 dividend payments to all Americans adults if the Republicans retain control of Congress in November’s midterm elections. It remains a question as to whether he can fulfill that promise.

The move comes at a time when many Obamacare enrollees are struggling to maintain their coverage – or have dropped their policies – after congressional Republicans allowed the enhanced ACA premium subsidies to expire at the end of last year. That sent premium payments skyrocketing for many enrollees, particularly middle-income folks, for 2026.

Premiums are set to jump again for 2027. Policyholders will learn how much more they’ll have to pay when open enrollment starts on November 1, just before the midterms.

In a video announcing the refunds, where Trump also urged Congress to pass his healthcare plan , the president said that the $500 rebate will cover the spike in premiums “in many cases.” But some enrollees saw their monthly costs increase by far more than that, according to KFF, a nonpartisan health policy research group.

The rebates will be funded from fees that participating Obamacare insurers pay to support the federal ACA exchanges’ operations, according to the White House. The fees, which insurers pass along to enrollees in the form of higher premiums, also pay for marketing, outreach and enrollment assistance.

About $1.2 billion in unspent fees had accumulated when former President Joe Biden took office in early 2021, according to an analysis by KFF, a nonpartisan health policy research group. The money had been adding up largely because the first Trump administration greatly reduced spending on enrollment assistance , marketing, the healthcare.gov website and the federal ACA call center.

The Biden administration subsequently announced it would pour about $500 billion into these ACA operations. Enrollment roughly doubled during his term to nearly 22 million people, thanks in large part to the enhanced subsidies , which Biden signed into in early 2021.

The current Trump administration is reducing the fees, which it argues will help lower premiums.

近百万美国人已收到《平价医疗法案》500美元的退款支票，同时收到唐纳德·特朗普总统的一封信，信中吹嘘了他在医疗保健方面的成就，并将责任归咎于他的前任。

美国财政部从周三开始向 30 个州的 95 万多名使用联邦医保交易平台 healthcare.gov 的奥巴马医改参保人发放一次性付款。

这些资金将来源于保险公司缴纳的未使用用户费用。特朗普曾表示，这些奥巴马医改的投保人在拜登执政期间被“错误地多收费”——一些专家对此说法提出异议。

退税款项将在中期选举前一个多月到账，而共和党人正努力保住对国会的控制权。医疗保健成本是选民们关注的主要问题，尤其是在许多人的保费和自付费用不断上涨的情况下。

特朗普在信中写道：“多年来，拜登政府向你们收取了过高的费用来资助HealthCare.gov的运营。这些钱属于辛勤工作的美国人，而不是政府，现在，我要把钱还给你们！”

“你们为这个有缺陷的体系付出了代价，现在你们终于得到了回报，”他写道，并列举了他为根除欺诈、降低药品价格和增加农村医疗保健支出所做的努力。

退款将发放给那些购买《平价医疗法案》（奥巴马医改）保险时未获得联邦保费补贴的投保人。（绝大多数奥巴马医改参保人都获得了补贴。）大多数退款受益人是收入超过补贴标准（个人年收入超过62,600美元或四口之家年收入超过128,600美元）的中产阶级美国人，白宫表示，他们今年的收入超过了补贴标准。

特朗普上个月宣布将发放退税，此前一天，他承诺如果共和党在11月的中期选举中继续掌控国会，将向所有美国成年人发放5000美元的股息。他能否兑现这一承诺，目前仍是未知数。

此举正值许多奥巴马医改参保人难以维持医保，或已放弃保单之际。此前，国会共和党人允许奥巴马医改的额外保费补贴于去年底到期，导致许多参保人，尤其是中等收入人群，2026年的保费飙升。

2027 年保费预计将再次上涨。保单持有人将在 11 月 1 日开放注册期开始时（中期选举前夕）得知他们需要多支付多少保费。

在一段宣布退款的视频中，特朗普总统敦促国会通过他的医改方案。他表示，500美元的退款“在很多情况下”将足以弥补保费的上涨。但据无党派医疗政策研究机构凯撒家庭基金会（KFF）称，一些参保者的月度保费涨幅远不止于此。

据白宫称，这些退款将由参与奥巴马医改的保险公司缴纳的费用提供资金，这些费用用于支持联邦《平价医疗法案》（ACA）交易平台的运营。保险公司会将这些费用以更高的保费形式转嫁给参保人，这些费用也用于市场推广、宣传和参保协助。

据无党派医疗政策研究机构凯撒家庭基金会（KFF）的分析，截至前总统乔·拜登于2021年初就职时，已累计约12亿美元的未使用费用。这笔资金之所以累积如此之多，主要是因为特朗普第一任期政府大幅削减了在参保协助、市场推广、healthcare.gov网站以及联邦《平价医疗法案》（ACA）呼叫中心方面的支出。

拜登政府随后宣布将向《平价医疗法案》（ACA）的运营投入约5000亿美元。在他任期内，参保人数几乎翻了一番，达到近2200万人，这主要归功于拜登在2021年初签署的增加补贴法案。

现任特朗普政府正在降低这些费用，并声称这将有助于降低保费。