Facts

Parties: Appellant A. against City of Zurich (Health Services)

Courts: Social Insurance Court of the Canton of Zurich, Federal Supreme Court

Date: January 19, 2023

Main question: Claim for premium subsidy for the year 2020 considering the income circumstances of the year 2020

Facts:

  • On April 1, 2020, the revised Introduction Act to the HIA (EG HIA) and the Ordinance to the EG HIA (VEG HIA) came into force in the Canton of Zurich.
  • Appellant A. applied for premium subsidies for the year 2020 on February 14, 2021, claiming a taxable income of significantly less than CHF 5,000.
  • The Health Services rejected the application, as according to the old law provisions, only the tax factors of the year 2019 were decisive.
  • The cantonal court confirmed the dismissal and saw no violation of federal law in the assessment gap.

Considerations

According to Art. 65 para. 3 sentence 1 HIA, the cantons must consider the most recent income and family circumstances when reviewing the conditions for premium subsidies. The cantonal provisions, which do not take into account the income circumstances of the year 2020, contradict this federal law.

The principle of the primacy of federal law under Art. 49 para. 1 Cst. excludes legislation by the cantons that violates the spirit and intent of federal law. The premium subsidy serves solidarity and is intended to alleviate the economic burden of health insurance premiums for persons in modest circumstances.

The cantonal provisions, which do not take into account the income circumstances of the year 2020, contradict the spirit and intent of Art. 65 para. 3 sentence 1 HIA. A transitional assessment gap, which results in the financial circumstances of the…