Trump announces $90 payments for seniors on Medicare ahead of midterm elections for premium costs

President Donald Trump is promising more payments to voters just ahead of the Nov. 3 midterm elections — this time, to more than 20 million seniors, giving them $90 each to help pay for Medicare premiums.

The announcement, made late Friday night by Trump on social media, comes after the president last month said about 1 million people would get rebate checks of $500 for Affordable Care Act premiums. He has also promised on the campaign trail to send every American adult $5,000 if Republicans retain control of the House and Senate in the midterm elections.

That pledge — which would require approval from Congress — would likely cost more than $1 trillion, adding to the deficit and worsening inflation.

Polls show Americans increasingly blame Trump for the high cost of gasoline and groceries with just 17% approving of his handling of inflation. Trump has sought to shrug off concerns about affordability, saying the economy is booming.

The White House said the $90 payments for seniors will come from the Medicare Improvement Fund, established by Congress in 2008 as flexible funding to improve program operations and payments to health care providers.

Medicare Part B enrollees can expect to receive a one-time payment in October, either through direct deposit or by check, the White House said. Total monthly costs for the program — which covers costs like doctor's visits, ambulance services and lab tests — start around $200 and vary with income.

To be eligible, seniors must be living in the U.S. and not be already receiving premium assistance from Medicaid or paying adjusted monthly premiums based on income, according to the Centers for Medicare and Medicaid Services. Seniors enrolled in Medicare Advantage, a private plan alternative to traditional Medicare coverage, are not eligible for the payment. More than half of eligible Medicare beneficiaries have Medicare Advantage, according to healthcare research nonprofit KFF.

Previous administrations have not used the Medicare Improvement Fund in this way, although Congress has periodically taken out money from the fund to pay for other priorities, said Larry Levitt, KFF's executive vice president for health policy. For example, $20.74 billion was used for the creation of the Affordable Care Act in 2010.

“The Medicare Improvement Fund language is quite broad and gives substantial discretion to the administration,” Levitt said.