With the midterm election looming, President Trump is ramping up his effort to convince Americans that voting for Republicans will pay off in a very direct way, thanks to his largesse.
Late Friday night, Trump announced that he is giving more than 20 million seniors on traditional Medicare a $90 rebate to help cover the monthly cost of the healthcare program. The one-time payments for Medicare Part B enrollees, which will cover less than half of the standard monthly premium of $202.90, are expected to arrive in early October via direct deposit or paper check.
Not all enrollees are eligible for the payments. Those on privately run Medicare Advantage plans — fully half of the roughly 64 million people on Medicare — are not eligible, nor are those who also receive assistance from Medicaid.
The payments will come from the Medicare Improvement Fund, which the White House said contains $2 billion in uncommitted funds. In the words of the legislation that created the fund, as highlighted by the Congressional Budget Office, the fund is intended “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.”
The White House highlighted the unusual nature of the payments. “Established in 2008, no Administration has ever utilized or made payments from the Medicare Improvement Fund,” a White House fact sheet says. “President Trump believes that Medicare Improvement Funds should be used to directly help people on Medicare, not special interests, and is returning healthcare dollars back into the hands of the American people to benefit them and their individual healthcare needs.”
More than one payment promise: Trump has also pledged to pay $5,000 to each adult citizen if Republicans successfully maintain control of Congress in the midterms. After introducing the idea of the “Trump dividend” in early September, the president repeated his pledge on his social media platform Saturday.
“If Republicans win the House of Representatives and the Senate, I’m going to give all adult citizens in the United States of America $5,000,” Trump said in a video post. “Thank you, and I look forward to signing those checks!”
Trump has not explained where the money for such payments would come from, nor how the payments would be authorized, though he did repeat his wildly exaggerated claim that he has drawn $21 trillion in new investment to the United States since returning to office. The promised $5,000 payments would cost more than $1.2 trillion in total, which Trump framed as a small portion of the unrelated and unproven investment total he often touts.
On a smaller scale, Trump is moving ahead with a plan to send $500 refund checks to about 1 million Americans in 30 states who get their health insurance through the federal exchanges established by the Affordable Care Act, or Obamacare. The checks reportedly are accompanied by a letter from Trump that states that the Biden administration overcharged some Obamacare participants.
According to Reuters, 71% of the Obamacare refund payments are going to people in states that are political battlegrounds, which could help tip the balance of close races. In New Hampshire, for example, where there are competitive races for the House and for governor, about 28,400 people will get the checks, or roughly 2% of the population.
A familiar pattern: Trump is no stranger to promising payouts to voters at government expense. Early in his second administration, he floated the idea of a $5,000 “DOGE dividend” that would share the bounty of savings that Elon Musk was supposed to deliver through massive cost-cutting throughout the federal government. Those checks, like the savings, never materialized.
Trump also raised the possibility of a payment of $2,000 per person based on the revenues generated by his tariff blitz in 2025. But the Supreme Court ruled that his “reciprocal tariffs” were unconstitutional, and no payments were ever made.
A few weeks before the 2020 election, during his first term, Trump attempted to make another healthcare-related payout, promising millions of Medicare enrollees $200 prescription-drug cards. But there was no funding for the cards, and they were never sent.