He says he makes just under $11 an hour, and after taxes, child support and other expenses, he brings home just enough to cover rent. And all the other bills? He has a second job to cover those. His wife has been looking for work for over a year, and his oldest daughter is in college.

There’s no room in the budget for health insurance.

“When I first got this job,” he says, of his night janitor position, “they informed me about different employee packages, benefits and all that.”

But Alexander says he can’t afford the employee portion of the health insurance premium. Many people who are working lower wage jobs may qualify for Medi-Cal, California’s version of Medicaid, if their incomes are low enough. But because Alexander had been turned down for Medi-Cal in the past, he presumed he still wouldn’t qualify, even under Obamacare.