Per capita GDP matters more in determining whether Vermont or California can better afford this. In fact, CA can better afford this than Vermont.
By comparison, Mississippi cannot afford this. They're basically supported by states like California; their economy is trivial and they're propped up by defense spending.
Why? Disagree with your reasoning, it's not about per-capita, it's about absolute numbers in the risk pool and ability for a large actor like CA to better negotiate prices down.
Why do you think Apple gets better prices than, e.g. Logitech for component parts? Because they order massively more, up-front, and with strict timetables for delivery.
By comparison, Mississippi cannot afford this. They're basically supported by states like California; their economy is trivial and they're propped up by defense spending.