The US government will send rebate checks of $500 each to about 950,000 enrollees in Affordable Care Act health plans. The payments, announced by President Trump on September 10, will start going out in October.

The checks will go to people in the 30 states that use the federal exchange, HealthCare.gov, who did not receive premium subsidies. Many recipients earn more than 400 per cent of the federal poverty line.

The White House says the money comes from a surplus of exchange user fees collected during the Biden administration. It says the fees exceeded operating costs and were passed to enrollees through higher premiums.

Separately, Trump has promised $90 payments to more than 20 million Medicare seniors from the Medicare Improvement Fund. Democrats have questioned whether both payments can be made without congressional approval.

No court has blocked either payment so far. Trump has also promised $5,000 checks to every American adult if Republicans retain control of Congress in the midterms.