A new federal refund program aimed at people who buy their own health coverage without any government subsidy traces its funding to an unusual place: not new appropriated money, but a surplus sitting inside a fee insurers already pay to operate on the federal insurance exchange. The White House disclosed the funding source in the same September 10, 2026 announcement that named the $500 payment amount, and the mechanism behind the money says as much about who is and isn’t included as the dollar figure does. For someone weighing whether to expect anything from this program, the fee structure explains both the size of the pool and its limits.
What the Exchange User Fee Actually Is
Insurers that sell qualified health plans through the federally facilitated marketplace, the version of the exchange the federal government runs directly in states that did not build their own, pay a per-enrollee user fee to the Centers for Medicare & Medicaid Services for the right to list plans on healthcare.gov. That fee funds the exchange’s operating costs — enrollment systems, customer support, outreach — and insurers do not typically absorb it themselves. According to the White House fact sheet announcing the refund, the fee is built into the premiums enrollees pay, meaning the cost of running the federal exchange is charged, dollar for dollar, to the people buying coverage through it.
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A Surplus the White House Says Was Never Spent
The administration’s central claim is that the fee collected more than the exchange needed to operate. The White House fact sheet states that the prior administration “accumulated a significant surplus of funds that were not used to benefit the Americans who paid these higher premiums,” describing years of fee collections that outpaced actual exchange running costs. That gap between what enrollees paid in and what the exchange spent is the pool the current refund program draws from, rather than a new appropriation from Congress or general tax revenue.
The Fee Itself Has Been Moving, and Now It’s Coming Down
The user fee is not a flat charge; it is set annually as a percentage of an enrollee’s monthly premium, and that rate has shifted noticeably in recent years. For 2025, CMS set the federally facilitated exchange fee at 1.5 percent of premium; for 2026, the rate rose to 2.5 percent. CMS then reversed course for the year after: in a May 15, 2026 final rule, the agency cut the fee to 1.9 percent of premium starting in 2027, saying the reduction was designed to “help put downward pressure on premiums.” That a rate the agency itself now calls higher than necessary sat at 2.5 percent through 2026 lends some support to the administration’s separate claim that prior years of collections outran the exchange’s actual operating costs.
Why No Dollar Total for the Surplus Has Been Published
Despite naming the $500 per-person payment and describing the population it will reach, the fact sheet stops short of disclosing the size of the underlying surplus itself. No aggregate figure for how much the user fee overcollected, over what span of years, or how the $500 figure was calculated from that total appears in the administration’s public materials. That leaves the arithmetic connecting the fee surplus to the specific per-person amount unverified against any published accounting, even as the eligibility criteria and payment figure are stated plainly.
Why the Funding Source Explains Who Is Left Out
Because the money originates in a fee tied specifically to the federally run exchange, the program’s boundaries follow the fee’s own reach. Only the 30 states that use the federal exchange rather than a state-run marketplace are included, and within those states, only enrollees who paid the full premium without receiving federal premium assistance are covered — the group whose premiums were the ones carrying the fee without an offsetting subsidy. Enrollees in state-based exchanges, and those who received premium tax credits that reduced what they personally paid toward the fee-bearing premium, fall outside the funding mechanism entirely, not because of a separate policy choice but because their premiums did not generate the same surplus.
A Mechanism Distinct From the Payment Timeline
The fee-surplus explanation is a separate question from when or whether any individual payment arrives, and the two should not be conflated. The fact sheet describes the funding source and the eligibility class in detail; it does not include an implementation page, a claims process, or a verification method through which an eligible enrollee could confirm their share of the fee-funded pool. Until the agency responsible for the federal exchange publishes an administering mechanism, the fee surplus remains an accounting explanation for where the announced money originates rather than a program with an active payment infrastructure behind it.
Inside the guide
A 5-tab Excel tracker pre-filled with all 51 state unclaimed-property offices, the source vault of 12 official places money sits, and a step-by-step filing walkthrough.
The Settlement & Refund Recovery System includes a 36-page guide, a 5-tab Excel tracker pre-filled with all 51 state unclaimed-property offices and the four-date rule for reading a settlement notice.
Open The Settlement & Refund Recovery System.
This article was produced with the assistance of AI and reviewed by The Financial Wire editorial team.
Warren Cohen is a finance writer based in Phoenix, Arizona, covering personal finance topics including credit, banking, and beginner investing. He earned his degree in business administration from Arizona State University and began his career working in consumer finance, where he gained direct experience with lending and credit systems. He now writes for personal finance websites and fintech platforms, focusing on clear, practical content that helps readers make informed financial decisions.
