President Donald Trump has in recent weeks unveiled multiple schemes to send checks to millions of Americans, adding letters explaining that funds are meant to help with healthcare costs. The move — unveiled weeks ahead of the midterm election — suggests an effort to encourage voters to forget Republicans’ recent destructive actions making healthcare harder to access and afford, experts told TPM.
Several experts also described at least one of the two check-mailing schemes as based on a “legally dubious” interpretation of how the executive branch may use the pool of funding it’s tapping into.
Over the past several weeks, the Trump administration made two announcements with promises of one-time checks — one for $90 and the other for $500 — to Medicare Part B enrollees and the Affordable Care Act (ACA) marketplace enrollees who do not receive premium assistance, respectively.
Experts pointed TPM to the timing of the checks, highlighting their proximity to the upcoming midterms.
“These checks definitely are, I think, the latest and greatest attempt of the administration to kind of save face ahead of the election and try and shift the narrative away from the unfortunate reality that they have spent the past two years dismantling every aspect of our healthcare system,” Natasha Murphy, director of health policy at the Center for American Progress, told TPM.
Since the start of his second term, the Trump administration and its allies in Congress have been assaulting healthcare on all fronts, from federal funding cuts to grant reductions; from federal employee layoffs to restrictions in access to care.
In the GOP’s signature reconciliation package, dubbed the One Big Beautiful Bill Act (OBBBA), congressional Republicans managed to make historic cuts to the Medicaid program in the sum of hundreds of billions of dollars that were projected to deal a sizable blow to states’ budgets and trigger Medicaid coverage losses for millions of Americans. The bill also, starting in 2027, imposes new, burdensome work requirements and more frequent eligibility checks for adults covered by the ACA Medicaid expansion.
Despite pushback from Democrats triggering a historic government shutdown, Republicans also allowed the ACA enhanced premium tax credits to expire at the end of 2025, causing millions of Americans to pay significantly more for their health insurance this year. The average monthly net premium costs among marketplace enrollees rose by 58% in the aftermath, according to a recent KFF analysis.
The ‘Legally Questionable’ Checks
Most recently, in a Friday night Truth Social post and White House statement, Trump announced a plan that he framed as an effort to help Medicare Part B enrollees — the portion of the program that helps cover outpatient visits — with their premiums through a one-time check.
“I am pleased to announce that my Administration will, immediately, begin sending ‘Checks’ of nearly $100 to over 20 MILLION wonderful Seniors to help pay for their Medicare Part B premiums,” Trump wrote.
To fund the payments, the White House announced it was diverting money from the Medicare Improvement Fund, which has a roughly $2 million remaining balance.
The fund was created in 2008 by Congress to make improvements to Medicare services. According to the statutory language, Congress authorized the fund “to make improvements under the original fee-for-service program under parts A and B for individuals entitled to, or enrolled for, benefits under part A or enrolled under part B.”
Trump’s plan is a stretch under that law, experts said. “What President Trump is doing here is legally questionable,” David Super, law professor at the Georgetown University Law School, told TPM.
“Neither the permanent law nor the most recent appropriation for the fund clearly prohibits payments to individuals to the point that a prosecution would be likely to result in a conviction,” Super continued. “But the fund’s language makes clear to anyone who cares to read it that it is intended to be spent reducing the costs of particular services for those who rely on those services, and across-the-board payments to offset premiums are certainly not that.”
The Centers for Medicare & Medicaid Services claims that the administration is allowed to use the fund in question because it is improving Medicare by helping it be more affordable for Americans.
“President Trump is the first president to actually use the Medicare Improvement Fund to improve Medicare by making the program more affordable for enrollees,” a CMS fact sheet published on Saturday claims.
Bobby Kogan, who served in the Biden White House as adviser to the director of the OMB, pushed back on that description, saying that “they’re not making an improvement to Medicare by just cutting everyone a $90 check.”
The Centers for Medicare & Medicaid Services did not immediately respond to a request for comment. The White House also did not immediately respond to a request for comment.
As the Trump administration and Russ Vought’s Office of Management and Budget has proved time and time again, what Congress intends when it writes an appropriation law and how the administration chooses to read and interpret it can be worlds apart.
“They’re clearly aggressively stretching the bounds of what these funds could be used for,” Devin O’Connor, senior fellow on the Center on Budget and Policy Priorities’ federal fiscal policy team, told TPM.
O’Connor added: “They’ve gotten so comfortable in breaking the law in past instances that they seem recklessly willing to stretch any definition to the breaking point as long as it allows them to do what they want to do — even if that means incurring massive legal risk in the process.
In addition to the questions around its legality, experts pointed out that a one-time check for less than $100 may not be the biggest help for those being crushed under the current affordability crisis.
“The check might be a quick temporary relief — maybe it helps someone fill out their gas tank one additional time but compared to folks’ healthcare costs it’s definitely a drop in the bucket,” Murphy said.
For 2026, the standard Part B monthly premium is $202.90, that’s more than $2,400 a year in premium payments for enrollees.
“Trump took away people’s healthcare and then he wants to come in just before the election and say ‘Oh, here is 90 bucks for you,’” Kogan, senior director of federal budget policy at the Center for American Progress, told TPM, adding, “That doesn’t even get close to making up for the harms he imposed upon people.”
The ‘PR Stunt’ Checks
About a month ago, the Trump administration announced another, similar scheme: it would be sending one-time $500 checks to a subset of ACA Marketplace enrollees, claiming that the “Biden Administration’s gross mismanagement” led to “hundreds of millions in Obamacare overcharges” which the Trump administration would now be returning to enrollees.
The checks are being sent to Americans who do not receive premium assistance under the ACA in the 30 states that use the federal exchange for the operations of their Obamacare markets.
Murphy told TPM the checks are “certainly unprecedented” and that it is “unclear whether this was an appropriate mechanism to utilize for supposed excess user fee funding.”
The checks were reportedly mailed to recipients last week and some have already said they have received them accompanied by a letter, signed by Trump, attacking Democrats and touting his so-called achievements in healthcare.
“Donald Trump is a con man. This attempt to sway Americans by sending them a check with less than 30 days before the midterm elections is deceitful,” Senate Budget Committee Ranking Member Jeff Merkley (D-OR) told TPM in a statement. “Hardworking families and seniors across this country are not fooled by these checks and know this is a political stunt by a desperate president. Costs are increasing on everything — from gas to groceries to healthcare — all thanks to Donald Trump.”
“These checks from the Con Man-in-Chief are a drop in the bucket,” Merkley added. “They will not change the minds of those preparing to cast their ballots because the American people know they cannot continue paying the high cost of Donald Trump’s actions.”
Rep. Shontel Brown (D-OH) called the checks a “PR stunt” on Thursday in a social media statement.
“After driving up healthcare costs, this is a slap in the face to all of us. And the timing… well the timing speaks for itself,” Brown said.
Murphy also emphasized that for so many, “$500 is really paling in comparison to the thousands of dollars that they have faced in higher monthly premiums since the enhanced tax credit expired in December of last year.”
“For the marketplace folks it’s really a drop in the bucket and not going to be a meaningful amount of money,” Murphy told TPM.
Nearly a hunnard dollars.
Is there a word stronger than desperation?
DJT is a corrupt slob totally unworthy of the office he holds.
I thought “maybe“ so I went to the Ye Good Olde Thesaurus and Merriam-Webster - if not a single word - at least came up with a phrase, “slough of despond.”
I kind of like that because “slough” suggests a swamp or sewage treatment plant. And that basically is where this check is coming from.
We each got a $90 deposit labelled from Soc Security.
Wow! I’ll now vote straight GOP ticket.
That $180 disappeared in a combo trip to the pharmacy and grocery store.