Last week, the Trump administration began sending $500 checks to roughly 1 million Obamacare enrollees in 30 states—a “refund” for what the administration calls “high costs imposed by the Biden administration’s gross mismanagement of Obamacare.”
In a video posted to X on September 10, President Trump said that his “administration is doing the right thing and giving the money back to the people who were wrongly ripped off,” adding that “in many cases, these refunds will cover the entire cost of your insurance caused by Democrats.”
The administration’s strategy, it appears to its critics, is to sway voters ahead of the midterm elections next month, as Republicans face potentially losing their majorities in both the House and Senate.
“This announcement is less about health policy and much more about the 2026 Congressional elections,” Jonathan Oberlander, a professor of health policy and political science at the University of North Carolina at Chapel Hill, told CNBC about the plan.
With high costs and inflation top of mind for many voters, the onetime payments may be a gambit to gain some ground back in the polls, similar to Trump’s separate promise to send $5,000 to Americans in the event that Republicans win in November.
Brad Woodhouse, a Democratic activist and executive director of Protect Our Care, an advocacy group, called the plan “an absolute joke” in a statement.
“At a time when people are scraping by to keep up with the high cost of groceries, rent, and healthcare, this $500 gimmick won’t even begin to dig them out of the hole that Trump and Republicans created,” Woodhouse said.
Trump also has a history of attempting to repeal or undermine Obamacare, officially known as the Affordable Care Act (ACA), which was one of President Obama’s crowning achievements when it was signed into law in 2010.
Will onetime checks move the needle?
A big question is whether $500 is enough to offset the increases in healthcare costs due to Trump administration and Republican policies—a range of changes that includes cuts to Medicaid and health-related federal agencies, as well as allowing for the expiration of ACA-related tax credits.
On an individual basis, it’s difficult to say. But broadly, the answer is probably no, particularly for the people who are eligible to receive Trump’s refunds: ACA enrollees who pay the full price of their healthcare premiums and do not receive federal subsidies to help reduce those premium costs.
Worth noting, too, is that the payments are only being sent to states that utilize the Healthcare.gov marketplace—which tend to lean Republican—rather than those running their own state exchanges.
Where is the money coming from?
“There is always a fund with the ACA exchanges that can be used for various things,” says Matt McGough, a policy analyst at KFF for the Program on the ACA and the Peterson-KFF Health System Tracker. “This is a pool of money that different administrations can use to put toward different things, but the pool is coming from user fees for people who enroll through healthcare.gov and pay the full premium,” he said.
Notably, these are people who would not have been affected by the expiration of the ACA’s enhanced premium tax credits, which were phased out at the end of 2025.
The phasing out of credits caused out-of-pocket healthcare premium costs to increase (and enrollment to decline), but again, the people eligible for Trump’s refunds were not seeing any subsidies anyway.
Still, that doesn’t mean their costs didn’t increase, as average premium costs have risen substantially over the past couple of years.
“Premiums grew in 2026 by an average of 18%, and are expected to grow by double digits in 2027,” says McGough. “These are people seeing their premiums increase 30-40% in two years.”
Depending on several factors, those premiums now cost upwards of $1,000 more per year than they did before, and McGough says that “the average benchmark premium, the second-lowest-cost plan, last year was $625 per month.”
Ultimately, he says, the $500 refund “doesn’t even cover, on average, a month’s premium.”
