More than 950,000 Americans are receiving one-time $500 refund checks connected to the Affordable Care Act (ACA). The Treasury Department began sending the payments on September 30, 2026, to eligible people in 30 states that use the federal HealthCare.gov marketplace. Recipients are also receiving letters signed by President Donald Trump.

According to the Trump administration, the refunds come from excess ACA marketplace user fees paid by insurers to operate HealthCare.gov. The administration says those costs were ultimately reflected in consumers’ premiums and that more money was collected than was needed to operate the federal exchange. The program is separate from Trump’s proposed $5,000 payment, which would require additional action by Congress.

The payments are limited to residents of 30 states, including Texas, Florida, Ohio, North Carolina, Michigan and Wisconsin. Most recipients are people who earned more than 400% of the federal poverty level and did not receive premium assistance. Some people between 100% and 400% of the poverty level may also qualify if they did not receive subsidies. Residents of states with their own ACA exchanges are not included.

Eligible recipients do not need to submit a new application. The government has identified those who qualify and is sending the payments automatically. The refunds arrive as healthcare affordability remains a major issue, particularly after enhanced ACA subsidies expired at the end of 2025. The rollout is also taking place shortly before the November 2026 midterm elections, adding a political dimension to the program.