The money traces back to “user fees” that insurers selling plans on HealthCare.gov pay to keep the federal marketplace running. These costs are ultimately passed along to consumers through premiums. Trump says the Biden administration set those fees higher than necessary and built up a surplus, and the White House is framing the checks as a return of that excess.

Refund recipients received a letter from Trump, which reads: “For years, the Biden Administration overcharged you to fund the operation of HealthCare.gov,” according to several outlets who have obtained the letter. “That money belongs to hard-working Americans, not the Government, and now, I am returning it to you!”

For 2026, the federal exchange fee was set at 2.5% of monthly premiums; the Centers for Medicare & Medicaid Services has since lowered it to 1.9% for 2027. The timing matters. The enhanced premium tax credits Congress passed during the pandemic lapsed at the end of 2025, and health policy research group KFF estimated subsidized enrollees who kept the same plan would see their annual premium payments more than double, from $888 to $1,904. Marketplace enrollment dropped in every state except New Mexico this year, according to KFF.

Who qualifies for the Obamacare refund checks?

The refund is narrow. You’re eligible only if you bought 2026 coverage through HealthCare.gov and didn’t receive a premium tax credit. In other words, you had to have paid full price.

Most recipients earn above 400% of the federal poverty level, though an administration official told CNBC that “some people” between 100% and 400% will also get a check. CNN reported the White House put this year’s subsidy cutoff at roughly $62,600 for an individual and $128,600 for a family of four.

The 30 states covered, per the White House, are: Alabama, Alaska, Arizona, Arkansas, Delaware, Florida, Hawaii, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, South Carolina, South Dakota, Tennessee, Texas, Utah, West Virginia, Wisconsin, and Wyoming.

If you live in one of the 20 states or Washington, D.C., that run their own exchanges, you’re out of luck even if you paid full price. An administration official told ABC News that’s because the federal government didn’t collect the user fees in those states.

How can I claim an Obamacare refund check?

You can’t. There’s no application, claim form, or deadline. The administration says it has already identified eligible recipients, and payments are going out automatically by paper check or direct deposit, along with a letter signed by Trump. Households with more than one eligible person may receive multiple $500 payments, the official told CNBC.

The White House originally said checks would begin in October, but the administration official told CNBC the first batch went out this Wednesday. It’s not yet clear how long delivery will take.

What should I know about the payout?

This is not the same as a medical loss ratio rebate. Under the ACA’s 80/20 rule, insurers that spend less than 80% of premium revenue on care must refund the difference—and those rebates come from your insurer, not the Treasury. In theory, you could receive both.

The refunds have drawn skepticism. ABC News noted Trump offered no evidence the Biden administration sat on unused surplus funds, and the Center for American Progress (CAP), a left-leaning think tank, has argued a $500 check won’t solve the “health care premium crisis.”

“Against a $780 average annual increase in premium payments and a $1,027 increase in deductibles, spread across the 19.2 million marketplace enrollees, President Trump has promised a one-time, $500 check for nearly 1 million enrollees with the highest incomes,” according to CAP. “Over 10 years, that’s a $500 million solution to a $350 billion problem.” The Hill noted the checks land just weeks ahead of November’s midterms, with roughly 19.2 million people enrolled in ACA plans—meaning fewer than one in 20 will qualify.

For this story, Fortune journalists used generative AI as a research tool. An editor verified the accuracy of the information before publishing.