How Obamacare Helped Paul, A Homeless California Man, Finally Get Insurance


SAN FRANCISCO, California — Hope isn’t an insurance policy.

This is the lesson that Paul, a 55-year-old San Francisco man with thin, wispy hair reminiscent of a benevolent mad scientist, learned three years ago when his closest friend died from cancer. She was diagnosed in early 2010. Four months later, lacking insurance and any means to pay for care, she died.

“That was an unbelievable eye-opener for me,” he said.

Most Americans are insured through their jobs. For them, getting health insurance is a convenience, the only cost a slightly-diminished paycheck every two weeks. Not for Paul. He doesn’t have money for a place to live, much less health coverage.


Things weren’t always bad for Paul, who preferred not to divulge his last name or have his photo taken. He had worked for a big technology company for years. When layoffs came following the dot-com bubble, he took a buyout and used the money to start his own IT consulting business. It was “thriving,” he explained. That is, until demand dried up after the 2008 market crash. His business went under and he was soon evicted by his landlords.

Once a paragon of Silicon Valley’s promise, he became emblematic of its often-ignored side: those who have been left behind.

“I never imagined I would wind up homeless,” he said, mournfully. After all, he’d grown up in a well-off middle class family and was remarkably resourceful, teaching himself computer science to take advantage of the tech boom.

He has been homeless for nearly five years, sleeping in his car and trying every day to find work. It’s been 12 years since he had health insurance. For Paul, health care has meant aspiring, an annual flu shot, and confidence he won’t get sick.

And even though he says he doesn’t feel like he’s in his mid-50s — “I’m 55, going on 28,” Paul joked — his best friend showed him just how dangerous it is to rely on hope.

How Obamacare will help

On Monday, Paul showed up at Project Homeless Connect, a services fair for homeless people held near the Castro district of San Francisco, unsure of what he’d find.


Paul had tried numerous times, unsuccessfully, to get health coverage over the past few years. The problem is that, even though he had no health care, no home, and no assets, he still wasn’t eligible for California’s Medicaid program, Medi-Cal. That’s because for years, only people who were elderly, disabled, or had dependent children were eligible for Medi-Cal. Childless adults like Paul were excluded from the system.

That is, until Obamacare.

One of the most important reforms in the Affordable Care Act is the expansion of Medicaid to cover anyone with an income at or below 133 percent of the federal poverty level. That currently stands at $15,282 for an individual or $31,322 for a family of four. (Last year, the Supreme Court ruled that states can choose not to comply with the Medicaid expansion; approximately half of states have blocked expansion, despite the fact that it’s fully-funded by the federal government for the first three years.)

For folks like Paul who were among the 45 million people in 2010 without health insurance because they weren’t covered by Medicaid and couldn’t come anywhere near being able to afford individual insurance, Obamacare is nothing short of a miracle.

I ran into Paul after his consultation with SF PATH, a federally-funded insurance program that has served low-income San Franciscans, but will automatically roll over all its enrollees into Medi-Cal beginning on January 1, 2014.

Even as some in the media have focused on technical glitches to paint Obamacare as hopelessly flawed, that was hardly Paul’s experience. After trying and failing to get health coverage for years, all it took was a brief sit-down for Paul to get enrolled.

“It was unbelievably easy,” he told ThinkProgress. “Five minutes.”

Health insurance won’t immediately transform Paul’s life. It won’t give him a permanent place to live. It won’t get him a job. But it will prevent his life from completely unraveling if he were to get injured or sick. It’s one less worry in an already-stressful life.


Especially for the poor, health care is both a necessity and a luxury. And thanks to Obamacare, the safety net won’t just be for those who can afford it.