Sherri Smith never thought it could happen to a solid middle-class woman like herself.

But last spring, the 24-year-old Los Angeles native became a MediCal recipient and joined the ranks of some 5 million poor Californians who receive free health care benefits at a total annual cost to the federal and state governments of $14 billion.

MediCal is California's version of Medicaid, which provides a safety net for about 31 million of the poorest Americans at a cost of more than $118 billion a year. But MediCal coverage is often second-class: Many doctors refuse to treat MediCal patients, and pharmacies sometimes decline to fill their prescriptions.

Under President Clinton's health care reform program, MediCal recipients would receive the same kind of insurance as other Americans, eliminating many of the barriers that now make it difficult for them to get care.

But this new status would come to her at a price. Instead of getting her care free, she would have to make a $10 co-payment for each doctor's visit, just like all other persons enrolled in the low-cost health care plan.

Smith grew up in a financially secure, if not affluent, family in Hawthorne. She graduated from high school, married a book distributor, had three kids, worked as a business manager, attended college and was living a comfortable life in Los Angeles.

When the five-year marriage broke up last year, everything began unraveling. One of her children had a serious vision problem and, because she had no insurance, Smith began pouring money into medical care.

"Financially, it just broke me," she said.

Then Smith lost her job, couldn't pay the rent and soon found that she was among the city's homeless.

"It was horrible," she said, "because I've never understood what it was like to struggle like this. I never knew what it was like to be this broke."

Once Smith was turned away from a private hospital because she had no insurance and no money for treatment for Anza, her 2-year-old girl with pneumonia. Smith spent hours on buses traveling to Los Angeles County-UCLA Medical Center to get help.

Finally, she became desperate enough last winter to apply for welfare and MediCal.

Smith and her children became eligible for MediCal benefits last spring, but she soon learned that her health care problems were far from solved. First of all, there was the task of finding a pediatrician who would accept MediCal's payment rate, which many physicians find substandard.