State Subsidy Programs

Supplementary data for states with their own premium assistance

Overview

Most states rely solely on federal APTC. A small number add state-funded premium subsidies on top. For these states, our calculation must account for both federal and state components.

Confirmed State Subsidies

California (CAPS + CAPC) ✅ Validated

Source: 2026 CA Premium Subsidy Program Design

Formula: Identical to federal APTC but with California's own (lower) applicable percentage table.

CAPS = (SLCSP - CA_contribution) - Federal_APTC
     = Federal_contribution - CA_contribution   (when CA% < Federal%)

California 2026 Applicable Percentage Table:

Income (% FPL)	Initial %	Final %
100% to 150%	0.00%	0.00%
150% to 165%	3.19%	3.91%
Above 165%	No state subsidy

CAPC: $1 per covered member per month (all enrollees, regardless of income)

Validation: Within $0.44-$8.29 of Covered California's displayed savings across 4 marketplace scenarios.

States Requiring Research

State	Program	Status
New York	Essential Plan / Basic Health Program	❌ Need to research
Colorado	Colorado Option	❌ Need to research
Washington	Cascade Care	❌ Need to research
Connecticut	State subsidy program	❌ Need to research
Others	Most SBE states have NO state subsidy	Federal APTC only

Implementation

State subsidy data stored in MongoDB state_subsidies collection:

{
  "state": "CA",
  "plan_year": 2026,
  "program_name": "CAPS + CAPC",
  "applicable_pct_table": [
    {"min_fpl": 1.00, "max_fpl": 1.50, "initial_pct": 0, "final_pct": 0},
    {"min_fpl": 1.50, "max_fpl": 1.65, "initial_pct": 0.0319, "final_pct": 0.0391}
  ],
  "per_member_credit": 1.00,
  "source_url": "https://board.coveredca.com/...",
  "last_verified": "2026-04-07"
}

For states without entries, federal APTC is the complete answer.