Healthcare costs are rising. What's Maryland doing about it?

What exactly can $500 get you when it comes to health care? How much does it cost to repair a broken leg? Will $500 cover that? Selena Simmons-Duffin is NPR's health policy reporter, and we have her on the line.

Selena, welcome to the engagement.

Hi, thanks for having me.

Thank you.

So let's start with these checks.

Why is the administration doing this, and where exactly is the money coming from?

Yeah, so the why, I think that the why that was sent out in the letter that came from President Trump that you mentioned explains that Obamacare, which is what President Trump calls the Affordable Care Act marketplace, it's at healthcare.gov. has been overcharging people and ripping people off.

And this is his way of getting money back to people who have been ripped off.

But I think that the real reason is pretty transparently because voters care a lot about health care and Republicans don't have voters trust when it comes to health care.

And this is an action that the president can take to try to kind of change the narrative on Republicans and health care in the weeks before the midterm.

And you mentioned that the checks wouldn't be coming to Maryland.

The reason for that is because the checks are only going to people who use the federal marketplace, healthcare.gov, and 12-ish states use a state-based marketplace, including Maryland.

And people who use the state-based marketplaces aren't eligible for these checks.

um and the last part of your question about where the money comes from the money is actually not taxpayer dollars it comes from insurance companies um that are you paying what are called user fees to the federal government to be able to participate in the federal marketplace um so insurance companies pay these fees and then normally you know they're used for you know, various things related to the program.

They have never before been used for direct payments.

And, you know, there have been questions about the legality of the use of these funds for these direct payments, but the payments have already gone out.

And I don't know of any legal challenges that would result in any change.

So I think that the ship has sailed in that sense.

You also spoke with a woman in West Virginia named Ellen Allen, who was paying nearly $2,000 a month for health insurance and had to dip into her retirement savings just to afford her premiums.

Then she got this $500 check.

What was her reaction?

Well, she was shocked that it actually happened.

President Trump has promised people direct payments many times in the past, and she really didn't think it was going to happen.

And so when the check arrived at her house, she was really surprised.

But I can't say that she was that impressed.