The conventional wisdom around Medicaid goes something like this: it’s a last resort, a program for people who have truly hit rock bottom. If you have a job — even a modest one — you’re supposed to figure it out on your own. That belief is not only wrong, it is costing working families thousands of dollars every year.
I met Benny Trujillo on a Tuesday afternoon in February 2026, inside a fluorescent-lit community center in San Jose’s Alum Rock neighborhood. He was seated at a folding table across from a volunteer tax preparer, a manila folder stuffed with W-2s balanced on his knee. The center was hosting a free tax preparation clinic through the IRS’s Volunteer Income Tax Assistance program, and Benny had driven forty minutes from his apartment to be there. When the volunteer finished with his return, Benny lingered. He looked like a man with more questions than answers.
I introduced myself, and he agreed to talk. We ended up sitting in those metal folding chairs for nearly two hours.
A Manager’s Salary That Never Quite Stretched Far Enough
Benny Trujillo has worked the front desk at a mid-tier hotel near San Jose’s downtown convention center for eleven years. He manages check-ins, handles complaints, trains new staff — the kind of invisible labor that keeps a hotel running. In 2025, his base pay came to roughly $37,800 before taxes. Some months, overtime bumped that number. Other months, when bookings dropped, his hours were quietly cut.
“The income looks okay on paper,” he told me, leaning back in his chair with the practiced calm of someone who has explained this frustration many times before. “But it’s never the same number twice. I can’t plan. I can’t save. Every time I think we’re getting ahead, something comes up.”
That something, most often, was his son Marco. Now nine years old, Marco was diagnosed with autism spectrum disorder at age three. He requires full-time therapeutic support — speech therapy, occupational therapy, applied behavior analysis sessions — and his care has consumed the family’s finances in ways that are difficult to fully describe.
Before 2024, Marco was covered under Benny’s employer-sponsored health plan. But in the fall of 2023, the hotel’s insurance carrier changed, and the new plan’s out-of-pocket maximum jumped from $4,500 to $9,200 per year. Applied behavior analysis — ABA — therapy, Marco’s most critical intervention, was now covered only at 50 percent after the deductible. The monthly bill Benny faced for Marco’s care alone reached $2,200 in January 2024.
“I put it on the credit card for three months,” Benny said. “Then the card was maxed. Then I took out a personal loan. That’s when my credit score fell apart.”
The Application He Almost Never Filed
Benny’s wife, Claudia, had heard about Medi-Cal — California’s version of the federal Medicaid program — from another parent at Marco’s school. But Benny resisted. He had spent his adult life working and had internalized the idea that applying for government assistance was an admission of failure, not a use of a program he had paid into through years of payroll taxes.
What Benny didn’t know — and what many working families in similar situations don’t know — is that children in California can qualify for Medi-Cal at significantly higher income thresholds than adults. Under the Children’s Medi-Cal program, a child in a family of three can qualify with a household income up to 266 percent of the federal poverty level, according to California’s Department of Health Care Services. For a family of three in 2024, that translated to roughly $60,000 in annual income — well above what Benny was earning.
A social worker at Marco’s school finally walked Claudia through the numbers in March 2024. She submitted the application through the Covered California portal the following week.
What the Approval Actually Covered — and What It Didn’t
Marco’s Medi-Cal approval arrived in May 2024. Benny described opening the letter as one of the stranger emotional experiences of his adult life. Relief, he said, but also a slow, complicated anger at how long he had waited out of pride.
Under California’s Medi-Cal program for children with autism spectrum disorder, Marco qualified for coverage of ABA therapy, speech therapy, and occupational therapy with no monthly premium and no out-of-pocket cost for covered services. The $2,200 monthly bill Benny had been absorbing dropped to zero for those services.
But the coverage was not seamless. Benny discovered that Marco’s existing ABA provider was not in the Medi-Cal network. He had to either find a new provider — which meant disrupting Marco’s established therapeutic relationships — or pay out of pocket for the current one while searching for a network alternative.
“We didn’t want to switch Marco’s therapist. He had built trust with her over two years,” Benny told me. “So we paid out of pocket for four more months while we fought to get her credentialed with Medi-Cal. That cost us another $8,800 we didn’t have.”
The provider was eventually credentialed in September 2024. The gap period left Benny with additional debt, though substantially less than he would have accumulated without applying at all.
SNAP Benefits and the Shame He Didn’t Expect
At the same tax clinic where I met Benny, a Benefit Enrollment counselor was offering screenings for other programs. Benny agreed to a screening — more, he said, out of curiosity than expectation. The counselor determined that his household likely qualified for CalFresh, California’s SNAP program, based on their net income after deducting certain medical expenses for Marco’s care.
California’s CalFresh program, which operates under the federal SNAP framework, allows households to deduct certain excess medical expenses for elderly or disabled members — and in some cases, dependents with disabilities — when calculating net income for eligibility. If approved, Benny’s household of three could receive an estimated $280 to $340 per month in food assistance.
Benny had not applied yet as of our conversation. He admitted that the same psychological resistance he felt about Medi-Cal was surfacing again. “A food stamp card,” he said quietly, and paused. “I never thought that would be my life. I’m not complaining — I know people have it worse. But it’s hard to swallow.”
Where Benny Stands Now
By late 2025, Benny’s financial picture had stabilized — though “stabilized” is a relative term. Marco’s therapeutic services are fully covered under Medi-Cal. The personal loan Benny took out in early 2024 carries a balance of approximately $11,400, at 19.9 percent interest. His credit score, which dropped to 561 at its lowest point, had climbed back to 604 as of January 2026.
His retirement savings — a 401(k) through the hotel — hold roughly $29,000 at age 54. He contributes three percent of his paycheck, the minimum required to capture the employer match. He knows it is not enough. He knows it with the specific, grinding awareness of someone who has done the math many times and found it doesn’t work.
As I packed up my recorder that afternoon, Benny mentioned that he had been too embarrassed to tell his coworkers about the Medi-Cal application. He worried they would judge him. I asked whether he’d tell them now, knowing what it had saved his family.
He thought about it for a moment. “I’d tell them to apply before they’re drowning,” he said. “Don’t wait until you’ve already wrecked your credit. I waited a whole year out of pride. That year cost me more than I want to think about.”
Benny Trujillo is not a cautionary tale about poverty. He is a cautionary tale about a system that is more accessible than most working people believe — and about the very human tendency to refuse help until the refusal itself becomes the damage.
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