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Trump sending ACA and Medicare checks, but will they offset costs?

by Aimee Picchi
October 5, 2026
Reading Time: 5 mins read
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Trump sending ACA and Medicare checks, but will they offset costs?

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President Trump is sending checks to millions of Medicare and Affordable Care Act enrollees, with the White House describing the efforts as helping to “lower costs” for seniors and families. But experts say the payments may do little to offset rapidly rising healthcare expenses.

On Friday, Mr. Trump announced on Truth Social that his administration this month will send checks of about $90 to more than 20 million Medicare participants in the program’s Part B plans. 

That announcement followed the White House’s Sept. 10 statement that $500 checks would be sent to about 1 million people who enrolled in an ACA plan this year through federal exchanges administered by the Centers for Medicare and Medicaid Services. The payments, described as refunds for overcharges, are for people who didn’t receive ACA insurance subsidies.

“President Trump is delivering on his promises to lower costs for American patients by putting them first and taking on the special interests that have used the status quo in Washington to raise healthcare costs for Americans,” the White House said in an Oct. 2 statement about the Medicare checks. 

While the payments will help defray some of the healthcare costs paid by senior citizens and ACA-enrolled households, the money may not go far enough, health policy experts said. Americans cite healthcare costs as one of their top financial concerns, with almost 30% saying they’ve skipped or postponed healthcare treatments in the last year because of costs, according to polling from nonprofit health policy research organization KFF.

“A plan to lower healthcare costs is welcome, but President Trump’s proposal to provide a one-time $90 payment to some Medicare beneficiaries will likely go unnoticed by most seniors,” Max Richtman, CEO of the nonpartisan National Committee to Preserve Social Security & Medicare, told CBS News. 

The White House said Mr. Trump is taking action to lower healthcare costs for millions of Americans. 

“President Trump is enabling Americans to take control of their health by putting money directly back in the hands of Medicare patients,” White House spokeswoman Allison Schuster said in a statement to CBS News. “In addition to guaranteeing discounted prices on prescription drugs through his Most-Favored-Nation drug pricing agreements, distributing $500 Obamacare Refund checks and increasing price transparency across the board, President Trump is delivering on his promise to lower costs for American patients by putting them first and taking on the special interests that have used the status quo in Washington to raise healthcare costs for Americans.”

Mr. Trump has also promised $5,000 “dividend” payments to every U.S. adult if Republicans retain electoral control of both the House and Senate after the November midterms. Some economists and other experts have raised doubts about the feasibility of the payments, as they would require Congress to authorize more than $1 trillion in spending and could reignite inflation.

The Trump administration began sending the ACA checks on Sept. 30, while the Medicare checks will be sent starting in early October.

Higher Medicare Part B premiums

Premiums for Medicare Part B, which covers medical services such as doctor visits, outpatient care and preventive screenings, rose by more than $200 annually in 2026, and are forecast to rise by another $79 next year, according to June projections in the Medicare trustees’ latest annual report. 

That means the $90 check could fall short of covering the increased costs that seniors are already paying this year alone for their Part B plans, according to Juliette Cubanski, vice president and director of the Program on Medicare Policy at KFF.

“Receiving a one-time payment of $90 under this new plan from the Trump administration could be helpful, but it may not stretch very far when people are staring down higher costs for gas, heating their homes this coming winter, putting food on the table, keeping up with their mortgage payments,” she said. 

Rising ACA costs

Meanwhile, the $500 ACA check isn’t likely to cover rising costs for people who get their health insurance through the program’s marketplaces, said Cynthia Cox, senior vice president and director of the ACA program at KFF.

The average premium for enrollees rose by $780 this year, up 58% from 2025, according to a KFF analysis. 

ACA plan costs have risen sharply in 2026, partly due to the expiration of enhanced premium tax credits, which Congress allowed to lapse in December. Those tax breaks had helped lower premium costs for millions of middle-class Americans. 

“People this year are paying significantly more than they were paying last year for health insurance on the individual market,” Cox told CBS News. “It’s going to help some people, certainly — getting a $500 check is better than not getting a $500 check — but for most people it won’t cover their full increased costs.”

A more effective method to lower healthcare costs would be to restore the enhanced ACA premium tax credits, Brian Keyser and Natasha Murphy of the Center for American Progress, a liberal-leaning think tank that supports the ACA, wrote in a Sept. 17 blog post. 

Millions left out

About 40 million Medicare Part B recipients don’t qualify for the $90 payment, while about 18 million ACA enrollees won’t get a $500 check, enrollment data for the programs shows.

The $90 checks will go to seniors enrolled in Part B under traditional Medicare who don’t pay income-related premiums or receive premium assistance from Medicaid. Seniors who are enrolled in Medicare Advantage plans are also excluded from the checks, according to the Centers for Medicare & Medicaid Services.

The Medicare check is reminiscent of President Trump’s proposal to send a $200 drug card to help seniors with out-of-pocket drug costs before the 2020 presidential election, Cubanski said.

While that plan never got off the ground, it was also timed just before an important election. The new Medicare payments, to be disbursed by direct deposit, are set to arrive only weeks before the Nov. 3 midterm elections. 

Sen. Ron Wyden, a Democrat from Oregon and ranking member on the Senate Finance Committee, on Saturday called the $90 checks an “attempt to bribe the American public.” But experts said the payments may barely register for some seniors.

“There’s a question whether many of these payments might go unnoticed,” Cubanski added. “People with Medicare get lots of mail from insurance companies and others trying to market plans during the open enrollment season, so this letter might get caught up in all the other mail that people are receiving.”

Edited by

Alain Sherter

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