Washington, D.C. — A new analysis from the Center for American Progress finds that President Donald Trump’s proposed one-time $500 checks for Affordable Care Act (ACA) marketplace enrollees would cover only a fraction of the higher health care costs families are facing after the enhanced premium tax credits expired. The “refunds” would prioritize households with the highest incomes, going only to nearly 1 million enrollees who do not receive premium tax credits, out of 19.2 million marketplace enrollees.
From 2025 to 2026, average monthly net premiums for marketplace enrollees increased 58 percent, or $780 annually, while the average deductible jumped 37 percent, or $1,027. Marketplace enrollment also fell 13 percent from February 2025 to February 2026.
“Families are paying hundreds or even thousands of dollars more for health coverage this year, and a one-time, $500 check does not come close to addressing those increases,” said Natasha Murphy, director of Health Policy at CAP and co-author of the analysis. “Millions of people who are struggling with higher premiums would get nothing at all. If policymakers want to meaningfully lower costs, they should restore the enhanced premium tax credits that helped families afford coverage year after year.”
Among the analysis’ findings:
- A $500 check would cover only a small fraction of many families’ premium increases. A 60-year-old earning $65,000 could pay more than $10,000 more for the same plan this year, meaning the check would cover less than 5 percent of the increase.
- Some households have seen their premium contributions more than triple. A 55-year-old couple earning $85,000 would see their annual contribution rise from $7,225 to $26,153. The $500 payment would cover less than 3 percent of that increase.
- Lower- and middle-income families would receive nothing. A family of four earning $75,000 is estimated to pay about $3,367 more this year but would not qualify because the family still receives premium tax credits.
- Consumers are increasingly moving into plans with higher out-of-pocket costs. Bronze plan selections rose from 7.3 million people in 2025 to 9.2 million people in 2026 as consumers sought lower monthly premiums.
- The administration’s proposal reaches only a small share of marketplace consumers. CAP concludes that restoring the enhanced premium tax credits would benefit people across the 19.2 million-person marketplace and allow people who have been pushed out of the market to regain coverage.
Read the analysis: “A $500 Check Will Not Solve the Health Care Premium Crisis” by Brian Keyser and Natasha Murphy
For more information on this topic or to speak with an expert, please contact Christian Unkenholz at [email protected].