In its judgment, the Federal Supreme Court (the Court) dismissed an appeal by the Compensation Fund of the Canton of Ticino (Cassa cantonale di compensazione) against a judgment of the Insurance Tribunal of the Canton of Ticino, confirming that, where entitlement to an individual premium reduction (RIPAM) is assessed outside the determinative tax data, the most recent figures must be used not only for the insured person's income but also for their minimum needs threshold.

The insured person had applied for a premium reduction for 2025. As the determinative tax assessment (2022) could not be used, the Fund established her income on the basis of the most recent data (2025), but applied the minimum needs threshold (limite di fabbisogno) of the preceding year, as prescribed for all cases by art. 18 of the ordinance implementing the Ticino act of application of the Health Insurance Act (RLCAMal/TI), and refused the application. The cantonal tribunal set that decision aside, holding that art. 18 RLCAMal/TI applies only where entitlement is assessed on the basis of tax data; outside the tax parameters, the most recent needs threshold applies.

The Court confirmed this interpretation. While the cantons enjoy considerable autonomy in structuring premium reduction schemes, their implementing provisions must not undermine the purpose of federal law: art. 65 para. 3 of the Health Insurance Act (HIA) requires cantons, at the insured person's request, to take account of the most recent economic and family circumstances. Applying an updated income while relying on an outdated needs threshold would compromise this objective. Court costs were imposed on the Fund.

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