Trump cracks open Medicare's untouched $2B fund for $90 senior checks: What the law says

Trump is unlocking a Medicare fund created in 2008 for the first time, directing $90 payments to more than 20 million Part B enrollees
The White House said the initiative was the first use of the Medicare Improvement Fund by a presidential administration (AP Photo/Alex Brandon)
The White House said the initiative was the first use of the Medicare Improvement Fund by a presidential administration (AP Photo/Alex Brandon)

WASHINGTON, DC: President Donald Trump is opening a little-used corner of Medicare financing to deliver one-time $90 payments to more than 20 million Medicare Part B enrollees, drawing attention to a fund created in 2008 that the Centers for Medicare and Medicaid Services had never spent.

The White House says payments will arrive in early October.

A Medicare fund never spent since 2008

The Medicare Improvement Fund was established in 2008 to support improvements to original Medicare’s fee-for-service program, covering Parts A and B.

WASHINGTON, DC - MAY 12: (Editor's Note: Alternative Crop) U.S. President Donald Trump, accompanied by Administrator for the Centers for Medicare & Medicaid Services (CMS) Mehmet Oz (L), Health and Human Services Secretary Robert F. Kennedy Jr. (2nd-R) and Food and Drug Administration (FDA) Commissioner Martin Makary (R), holds up an executive order aimed at reducing the cost of prescription drugs and pharmaceuticals by 30% to 80% during an event in the Roosevelt Room of the White House on May 12, 2025, in Washington, DC. Trump announced his plan to lower drug prices would tie their cost to drug prices paid in foreign nations. (Photo by Andrew Harnik/Getty Images)
The Medicare Improvement Fund was established in 2008, but CMS reported no outlays from it through 2023 (Andrew Harnik/Getty Images)

A 2023 Congressional Budget Office report found that CMS had made no outlays from the fund since its creation. 

CBO also found that lawmakers had changed its available amount 28 times, increasing it 11 times and reducing it 17 times.

The latest law provides $2.062 billion for expenditures from the fund for services furnished during and after fiscal year 2027.

The ACA-era fund reduction

The fund also has a major connection to the Affordable Care Act. 

U.S. President Barack Obama signs S. 517, Unlocking Consumer Choice and Wireless Competition Act in the Oval Office at the White House August 1, 2014 in Washington, DC. S. 517 promotes consumer choice and wireless competition by permitting consumers to unlock mobile wireless devices among other things. (Chip Somodevilla/Getty Images)
Congress reduced the amount available in the Medicare Improvement Fund by about $20.7 billion through the 2010 healthcare law (Chip Somodevilla/Getty Images)

CBO records show that the 2010 health law reduced the amount available by about $20.7 billion.

The White House describes that change as Democrats “raiding” the fund and says previous Congresses used it in ways that increased healthcare costs.

How Trump plans to use it

Trump announced that more than 20 million beneficiaries will receive $90 each to help pay Medicare Part B premiums.

The White House says the initiative will be the first use of the Medicare Improvement Fund by a presidential administration.

TORRANCE, CALIFORNIA - JANUARY 21: (EDITORIAL USE ONLY) U.S. Air Force 1st Lt. Allyson Black, a regi
The administration says the payments will help eligible Medicare Part B enrollees cover their premium costs (Getty Images)

The statutory language says the fund is available to the HHS secretary to make improvements to original Medicare and adjust payments for healthcare services.

It does not specifically describe a $90 payment to beneficiaries.

The White House calls the move a way to lower seniors’ costs and says the fund should directly benefit Medicare recipients. 

Under the statute, the fund supports original fee-for-service Medicare, rather than Medicare Advantage, making the administration’s chosen mechanism central to the announcement.

Therefore the distinction is important to understand. 

At least $1.8 billion in payments

At $90 for 20 million people, the announced payments would total at least $1.8 billion.

That is about 87% of the $2.062 billion amount currently authorized for the fund. 

BIRMINGHAM, ENGLAND - MARCH 16:  A surgeon and his theatre team perform key hole surgery to remove a
More than 20 million payments of $90 would account for roughly 87% of the fund's currently authorized $2.062 billion amount (Getty Images)

The White House says most Medicare Part B enrollees qualify.

People whose Part B premiums are already paid by Medicaid and beneficiaries who pay an Income-Related Monthly Adjustment Amount are excluded.

What seniors will see this month

Eligible beneficiaries are expected to receive the money in early October.

Those with direct deposit will receive electronic payments, while others will get checks at their Medicare mailing address. 

President Donald Trump speaks with reporters during the swearing in ceremony for Homeland Security Secretary Markwayne Mullin in the Oval Office of the White House, Tuesday, March 24, 2026, in Washington. (AP Photo/Alex Brandon)
Most eligible beneficiaries are expected to receive the one-time payment electronically or by mail in early October (AP Photo/Alex Brandon)

Reports state that the administration is distributing $500 payments to nearly one million Americans who were overcharged for Affordable Care Act plans.

Trump has also continued promoting a proposed $5,000 “Trump Dividend” for US citizens if Republicans retain control of Congress after the midterm elections.

The $90 Medicare payment is separate from that proposal.

For seniors receiving the new payment, the administration says $90 will be applied toward Part B premium costs this month.

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