The Trump administration says it will mail $500 checks to nearly one million Americans in 30 states to refund what it called “overcharges” from ACA exchange fees collected under the Biden administration.
On Sept. 10, the White House said insurers that sell plans on the federal exchange pay user fees to fund the platform’s operations, and that those fees generated a surplus that was never returned to consumers. The refunds, which are set to go out starting in October, will be provided to enrollees who did not receive premium tax credit assistance and paid the full cost of their premiums.
The ACA marketplace has been facing its most turbulent stretch in years after enhanced premium tax credits expired at the end of 2025. Enrollment has fallen to roughly 19.2 million as of February, down nearly 3 million from a year earlier, as premiums have risen. Major insurers have also been pulling back from the exchanges, with those remaining pitching a median 15% rate increase for 2027. A handful of states have started finalizing rates for next year here.
At the Becker's 11th Annual IT + Revenue Cycle Conference: The Future of AI & Digital Health, taking place September 14–17 in Chicago, healthcare executives and digital leaders from across the country will come together to explore how AI, interoperability, cybersecurity, and revenue cycle innovation are transforming care delivery, strengthening financial performance, and driving the next era of digital health. Apply for complimentary registration now.
