Sage Lewis has expressed skepticism and criticism regarding the Housing First approach. In one of his blog posts, he discusses findings from a study by the IZA Institute of Labor and Economics, concluding that while Housing First may initially help by providing homes and increasing employment, the long-term gaps between participants and non-participants shrink, suggesting that many chronic issues associated with homelessness aren't resolved by housing alone.

Lewis also critiques the notion of Housing First from personal and practical standpoints, arguing that it cannot work effectively without considering the complexities of homeless individuals' lives—such as addiction and mental health issues. He believes that a tiered approach to sheltering—starting with tents for those not yet ready to re-engage with society and moving towards more structured housing—is more realistic and necessary.

Thus, while he acknowledges the importance of providing shelter, he is critical of the Housing First model as a standalone solution.