Medicare Part B checks worth about $90 are being sent to more than 20 million Americans, while around one million Affordable Care Act enrollees are receiving $500 payments. The Trump administration says the money will help lower healthcare costs, but policy experts warn that it may do little to offset rising premiums.
The Medicare payments, announced by President Donald Trump, are due to be distributed by direct deposit from early October. They will arrive only weeks before the November 3 midterm elections.
The White House said the payments would put money “directly back in the hands of Medicare patients” and described them as part of a wider effort to tackle healthcare costs.
Allison Schuster, a White House spokeswoman, said the administration was also pursuing discounted prescription drug prices through its Most-Favoured-Nation agreements, $500 Obamacare refund cheques and greater price transparency.
Medicare costs rise as payments are issued
The $90 payments are available to people enrolled in traditional Medicare Part B who do not pay income-related premiums or receive premium assistance through Medicaid. People enrolled in Medicare Advantage plans are excluded.
Part B covers services including doctors’ appointments, outpatient care and preventive screenings. Its premiums rose by more than $200 a year in 2026 and are projected to increase by a further $79 next year.
Juliette Cubanski, vice-president and director of the Medicare policy programme at KFF, said the one-off payment could help but might not go far when households were also facing higher costs for fuel, heating, food and mortgage payments.
Max Richtman, chief executive of the National Committee to Preserve Social Security and Medicare, said the proposal would “likely go unnoticed by most seniors”.
Some 40 million Medicare Part B recipients do not qualify for the payment. Cubanski also questioned whether all eligible recipients would notice it, saying the letter could be lost among the marketing material many people receive during the open-enrolment period.
ACA refunds set against higher premiums
The administration began sending $500 ACA cheques on September 30 to about one million people who bought plans through federal exchanges this year and did not receive insurance subsidies. The payments have been described as refunds for overcharges.
However, the average premium for ACA marketplace enrollees rose by $780 this year, an increase of 58 per cent from 2025, according to a KFF analysis.
Cynthia Cox, senior vice-president and director of KFF’s ACA programme, said the payments would help some households but would not cover the full increase in costs for most people.
Premiums have risen partly because enhanced tax credits that reduced the cost of ACA plans for millions of middle-class Americans expired after Congress allowed them to lapse in December.
Brian Keyser and Natasha Murphy of the Center for American Progress said restoring those enhanced premium tax credits would be a more effective way of reducing healthcare costs than issuing one-off payments.
Polling by KFF found that almost 30 per cent of Americans had skipped or postponed medical treatment in the previous year because of costs.
The payments have also attracted political criticism. Senator Ron Wyden, a Democrat from Oregon and ranking member of the Senate Finance Committee, called the $90 Medicare cheques an “attempt to bribe the American public”.
