The Trump administration announced Thursday it will issue $500 rebates to nearly one million people insured under the Affordable Care Act, framing the payments as refunds for "overcharges" by the previous administration. Eligible consumers in 30 states who purchased coverage through healthcare.gov without federal subsidies will receive checks next month, weeks before the midterm elections. The rebates target farmers, ranchers, entrepreneurs, and early retirees earning over $65,000 annually who faced steep premium increases after pandemic-era subsidies expired.

President Trump claimed on X that the Biden administration "massively overcharged" enrollees, attributing up to $500 million in excess fees. However, KFF executive Larry Levitt countered that Biden actually lowered marketplace user fees, and some unspent funds were meant for enrollment outreach. The $500 payment makes only a small dent in premium hikes that reached thousands of dollars.

Residents in 20 states and D. C. operating their own marketplaces — including California, New York, and Pennsylvania — are excluded. Lower-income enrollees and the roughly three million who dropped coverage after subsidies ended also receive nothing.

The move echoes Trump's 2020 proposal for $200 Medicare drug vouchers and pandemic relief checks, reinforcing a pattern of direct payments ahead of elections.