On September 10, 2026, the day after Trump promised $5,000 to every adult if Republicans keep Congress (see Trump Promises Every Adult Citizen a $5,000 'Trump Dividend' if Republicans Keep the House and Senate), the White House announced a separate payment: $500 rebate checks to nearly 1 million Affordable Care Act enrollees in 30 states, which it attributed to Biden-era exchange “user fees” that it said overcharged consumers, leaving “a surplus of unused exchange fee collections.” Trump said the checks would go to “hardworking Americans in 30 states” at “their home address.” ABC reported it was not clear where the money currently sits, how it would be distributed, or whether Congress must approve it.
On September 30 the administration began sending $500 payments to more than 950,000 people in the 30 states on the federal exchange, most of them earning more than 400% of the poverty line, with a letter signed by Trump: “For years, the Biden administration overcharged you to fund the operation of HealthCare.gov,” and, “That money belongs to hard-working Americans, not the Government, and now I'm returning it to you!” The White House says the money comes from a $500 million fund of excess user fees that insurers pay to run healthcare.gov. STAT reported in September that it is unclear what legal authority lets the administration give cash to only some ACA enrollees. UNC health policy professor Jonathan Oberlander: “It's part of a broader effort by President Trump to buy continued Republican control of the House and Senate via promises of direct government payments to voters.” The payments arrive about five weeks before the midterms.
A Reuters analysis published October 1 maps where the checks are going. Only residents of the 30 states on the federal HealthCare.gov marketplace qualify, and those states hold “Eight of the nine US Senate races that nonpartisan analysts regard as the most competitive,” along with 10 of the 12 most competitive governor's races. “Some 71% of the Trump administration's payments -- $339 million in total -- will go to people who live in those 13 states, according to a Reuters analysis of US government data.” Of the 19 million people with Obamacare coverage, 950,000 will get a payment. “The White House did not respond to accusations they are trying to influence the election,” Reuters reported. New Hampshire's Democratic Senate nominee, Chris Pappas: “Voters aren't looking for Donald Trump to cut them a check.” Cornell political scientist Douglas Kriner said the payments “might be worth a percentage point or two.” KFF's Cynthia Cox said the $500 “likely for the majority of them is not going to offset how much more they're paying for their premium this year.” Reuters also noted a precedent on the other side: Biden's $2,000 promise in the 2021 Georgia runoffs, partly delivered as $1,400 checks.