President Donald Trump just announced a plan that could put money back in the pockets of nearly 1 million Americans. The president’s new Obamacare refund proposal targets specific enrollees across 30 states ahead of the midterm elections.
How Donald Trump’s ACA proposal could affect health insurance costs
President Donald Trump announced Thursday that the federal government will issue $500 refunds to nearly 1 million Affordable Care Act enrollees starting in October, according to CNBC. The refunds target people in 30 states that use the federally run healthcare exchange. A White House official said recipients are largely middle-income households without current federal premium assistance.
The payments arrive after enhanced ACA premium subsidies lapsed at the end of 2025. Congress’s Republican majority had defeated Democratic efforts to extend those subsidies. Households earning above 400% of the federal poverty line then lost all access to ACA subsidies. That threshold sits at roughly $63,000 for individuals and $129,000 for families of four.
Health policy experts question whether the refunds can meaningfully offset rising premiums. Larry Levitt, executive vice president for health policy at KFF, wrote that “there’s no doubt middle-income ACA enrollees who are no longer getting premium subsidies would welcome $500 checks, but this would be a drop in the bucket for many of them compared to the thousands of dollars more they’re paying with the expiration of the enhanced tax credits this year.”
The subsidy expiration has already driven significant coverage losses across the country. ACA marketplace enrollment declined by about 3 million people, or 13%, from figures a year earlier. The Department of Health and Human Services reported that figure in June. Many enrollees dropped coverage entirely or downgraded to cheaper plans with less protection.
Jonathan Oberlander, a professor at the University of North Carolina at Chapel Hill, called the policy a form of “damage control.” He added that “this announcement is less about health policy and much more about the 2026 Congressional elections.” The White House attributed the refunds to surplus user fees from what it described as excessive charges during the Biden administration.
