It represents the latest payout that the President has made or promised Americans ahead of midterm elections, at a time when 66% of rural voters are worried about affording health care for themselves or their families, according to a KFF/AP poll released Sept. 23. The same survey found that 54% disapproved of Trump’s handling of health care.
“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, which we have already reduced by significant amounts,” the President wrote in a Truth Social post.
The Administration is presenting the rebates as another way to improve the program by making coverage more affordable. The U.S. Centers for Medicare and Medicaid Services (CMS) said in an FAQ that the payments would put money “in the hands of our Medicare beneficiaries.” It does not spell out the legal basis for using the fund to send checks directly to enrollees.
The CMS said most eligible beneficiaries will receive the $90 payment by direct deposit in early October, while others will receive a mailed check.
Trump touted these refunds during a rally in Vandalia, Ohio, during which he claimed that his Administration had already sent out nearly a million $500 refund checks—with about 70,000 going to families in Ohio.
The White House said that the refunds come from a surplus of ACA marketplace user fees collected under the Biden Administration, which it claimed exceeded the amount needed to operate the federal exchange.
The distinction between a one-time payment and recurring costs is crucial, says Lindsay Allen, a health economist and policy researcher at Northwestern University’s Feinberg School of Medicine.
According to the CMS, the standard monthly Medicare Part B premium rose from $185 in 2025 to $202.90 in 2026. That amounts to an additional $214.80 over a full year, meaning a $90 rebate would cover about 42% of the annual increase for eligible enrollees paying the standard premium—or less than half of a single month’s payment.
New census data this year also found that the poverty rate has increased the most for Americans 65 and older, growing from 9.1% in 2020 to 13.1% in 2025.
The Senior Citizens League projects a 3.5% increase for 2027, though the official adjustment will be announced Oct. 14. An increase of that size would raise average monthly benefits from $1,941.76 to $2,009.72. These annual adjustments are designed to help ensure that beneficiaries’ monthly payments help them keep pace with inflation, and an increase—potentially the largest cost-of-living adjustment since 2023—underscores the continuing pressure of rising prices on older Americans.
Public dissatisfaction extends across the economy and the war in Iran. An AP-NORC poll released Oct. 1 found that 65% of Americans attributed higher-than-usual prices to Trump’s policies, while 64% said he had gone too far in imposing tariffs. The same survey found that 69% believed the Iran war had not been worth fighting. About half (49%) of respondents said they were “extremely” or “very” concerned about being able to fill their tanks, up from 39% in July.
How much will Trump’s Medicare rebate help?
Several Trump Administration policy decisions will soon begin affecting Medicare and other health care programs for senior adults.
“It is likely to make it harder for older adults and people with disabilities to access and afford needed care,” the group said in its response to the decision in July, urging the Administration to reconsider.
Allen doubts that the refunds can offset the big issue at hand: “Medicare costs are increasing every year, but incomes for older adults aren’t.”
“This is particularly true because lower-income Medicare enrollees, for whom every dollar is most important, are not eligible for the checks,” Dow says. Beneficiaries whose premiums are already paid by Medicaid do not qualify, according to the White House.
She points out that premiums are likely to go up again in 2027.
This is nothing new, she says. Administrations of both parties have previously timed the distribution of benefits to correlate with elections.
“The payment is also limited relative to everyday expenses,” Allen says. “At current prices, $90 will get you about one tank of gas.”
“While perhaps good politics on the eve of an election, these checks are being paid from a fund intended by Congress to improve Medicare operations,” he says. “By diverting these funds, the long-term net effect will instead be to undermine Medicare operations.”
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