White House announces $500 ACA refunds

On Sept. 10, the White House announced it would, starting in October, send $500 refunds to nearly 1 million people who bought health insurance on the federal Affordable Care Act (ACA) marketplace.

The payouts likely won’t make a major dent in enrollees’ health costs, however, Matthew Fiedler, senior fellow with the Center on Health Policy at nonprofit research organization Brookings Institution, told Healthcare Brew.

For one, that payment wouldn’t cover this year’s premium increases or next year’s planned increases. The average premium increased $65 a month, or $780 a year, according to KFF data. The rise was fueled, in part, by the expiration of enhanced premium tax credits, also referred to as subsidies. The refunds are also limited in scope and likely to be a one-time deal, Fiedler added.

“Essentially all marketplace enrollees have experienced large premium increases this year. This…partially offsets it on a one-time basis for only a small slice of those enrollees,” he said.

The details. The White House said in a fact sheet that payments are coming from a “significant surplus” of user fees that were collected during the Biden administration and “passed on” to consumers via their premiums.

The government charges issuers these fees in order to fund marketplace operations. This fee varies from year to year based on factors like projected enrollment. It was 2.5% in 2026 and was lowered to 1.9% for 2027.

“CMS issued a rule lowering the fees moving forward to avoid the federal government over collecting and again find itself holding a pot of money that it did not need to operate the marketplaces,” a White House official told Healthcare Brew.

The payments will be sent via direct deposit, the White House told us, and are only going to people who do not receive premium tax credits. This means the vast majority of the estimated 19.2 million people with ACA exchange plans as of February 2026 aren’t eligible. Recipients must also live in one of the 30 states that use the federal ACA marketplace, as opposed to a state that operates its own marketplace.

The impact. Fiedler said he has “never seen” marketplace user fees used in this way. Subject matter experts also told Reuters and Stat that, to their knowledge, this is unprecedented.

In the past, user fees have funded services such as the ACA’s navigator program, which provides free enrollment assistance. In August 2024, under the Biden administration, the Centers for Medicare and Medicaid Services announced up to $100 million a year, for five years, in grants for the navigator program.

In February 2025, under the Trump administration, CMS slashed that funding to $10 million a year, arguing the bump hadn’t significantly raised the rate of navigator-assisted enrollments. That effectively freed up hundreds of millions of dollars in extra user fees.