WASHINGTON — President Donald Trump has begun sending $500 “refund” checks, along with a signed letter taking credit for the payments, to Americans who get their health insurance through the Affordable Care Act.

The letter assails the Biden administration and Obamacare while touting the Trump administration’s efforts to lower healthcare costs. The money is being distributed to nearly 1 million Americans less than a month ahead of the midterm elections, giving a last-minute financial boost to voters who will decide if Republicans will maintain control of Congress.

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

The money comes from a fund used to oversee the management of the insurance marketplaces. It developed a surplus because so many people enrolled in coverage during the Biden administration and because the Trump administration cut back on certain long-standing uses for the money, such as advertising and enrollment assistance.

The checks are designed as a one-time payment, but the consumers who get them will face high prices for insurance again next year. The marketplaces open for enrollment on Nov. 1, and early filings show insurers are asking for increases of around 15%.

For years, Trump and Republicans vowed to repeal the Affordable Care Act. After failing to do so, they have taken steps to weaken the 2010 health law by curbing insurance subsidies.

The $500 checks benefit consumers who faced significant insurance price increases this year, after the Republican-controlled Congress did not extend more generous subsidies, or tax credits, that were approved during the coronavirus pandemic.

Many farmers, ranchers, entrepreneurs and early retirees, people who earn more than around $65,000 a year and do not get health coverage from their jobs, could receive the money.

People in 30 states who signed up for Obamacare insurance on heathcare.gov and did not receive a federal subsidy would be eligible, according to a White House fact sheet that was published in September.

The checks could disproportionately be delivered to Republican-leaning states. Consumers in California, Colorado, Connecticut, Georgia, Idaho, Illinois, Kentucky, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Jersey, New Mexico, New York, Pennsylvania, Rhode Island, Vermont, Virginia, Washington and the District of Columbia will get no money. Those states manage their own insurance marketplaces, and insurers there do not pay fees to the federal government.

Separately, the Trump administration issued $90 direct deposits this week to the bank accounts of 20 million senior citizens to offset their Medicare premiums. The money is coming from the Medicare Improvement Fund, which Congress established in 2008.

Trump is sending out money as polls show that Republicans could lose control of the Senate and the House of Representatives in November. The president has previously promised financial handouts ahead of elections in an attempt to sway voters.

During Trump’s first term, just before the 2020 election, he proposed sending $200 vouchers to Medicare beneficiaries to lower their drug costs. The plan was later abandoned. Last month, Trump floated the idea of mailing $5,000 to American households next year if Republicans retain their congressional majorities. He also announced tax-free “warrior dividend” payments of $1,776 to active military service members.

In his letter, Trump took credit for lowering drug prices and rooting out fraud in the healthcare system.

“I am proud to return your money to you, and I will never stop fighting to put the American People FIRST, restore Affordability, protect your hard-earned money, and lower the Cost of Healthcare,” Trump said.

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This article originally appeared in The New York Times.

By Alan Rappeport/Kenny Holston
c. 2026 The New York Times Company