White House says it will send $500 Obamacare refunds to nearly a million Americans
XLV•Why the fees were collected
Health insurers who offer plans under the ACA on Healthcare.gov pay the government a user fee to sell plans on the federal exchange, set annually by the Centers for Medicare & Medicaid Services as a percentage of premiums.
The user fees help pay for the Healthcare.gov website, its call center and grants to "navigator" groups that assist people in enrolling in the plans, said Cynthia Cox, director of the ACA program at KFF, a health policy research group.
The fee is set roughly a year in advance. The 1.5% rate for 2025 and the 2.5% rate for the current 2026 plan year were both finalized by the Biden administration, which projected higher fees to offset an expected enrollment drop when the COVID subsidies expired.
The Trump administration's first payment rule, issued in May, cut the fee to 1.9% for 2027.
Insurers build the fee into premiums, so consumers do not see it as a separate charge. A surplus does not mean consumers were overcharged, Cox said, attributing it largely to the current administration's decision to cut spending on programs like the navigators while continuing to collect the fee.
