It’s Enough to Make You Sick

Oh, it looks simple. Perky, even, considering that it’s health insurance paperwork. “Step One,” it says. “Estimate your family’s income.” How hard can that be on a document decked with cartoons?

“Write down the gross income/earnings in the correct box(es) for how often you are paid.” Here you start to squint. Weekly numbers go in Box A, every two weeks, Box B. Twice monthly? Monthly? Yearly? C, D, E. If your pay varies, they want you to average, but the form doesn’t say so. It does say to multiply by a factor of either 4.33 or 2.167 or 2 or 1 or divide by 12.

Any other adults in the household? List them, unless they’re the wrong adults. Who are the right adults? It doesn’t say. Now list all the kids. Are they citizens? Permanent residents? Aliens paroled into this country under Section 212(d)(5) of the INA for a period of at least one year?

On and on the questions go, 28 pages of perky, murky, mind-bending prose. If the stakes weren’t so high and the people so needy, it would be almost comical. But the program involved is a $500-million initiative to get health coverage for the children of the working poor--whose parents are having one heckuva time just figuring out how that #%$#&!# application works.

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My, but this state struggles with the notion of doing the right thing. California reminds me of a neighbor I used to have who couldn’t give a present without borrowing it back. Any time the government commits an act that vaguely resembles kindness, you can bet that it won’t be long before everyone involved starts attaching strings just to prove we’re nobody’s sap.

This week’s case in point--a much-heralded, 3-month-old program known as Healthy Families--is but one more example of the way the state makes the average Californian wonder: Are those people in Sacramento acting in good faith, or does someone have it in for me up there? The answer lies, of course, in the essential ambivalence of the average Californian himself/herself (as the government might put it).

Let me say up front that Healthy Families is not a bad program. Passed last year, it basically offers the children of low-paid, uninsured workers the same annoying HMO coverage enjoyed by children in the middle class. You pick a version and pay a premium that is kept low by a state subsidy. The most expensive one runs about $27 a month.

It is, however, a program that evoked mixed feelings from its conception, when President Clinton offered big federal grants to states that expanded health insurance for the sons and daughters of gardeners, deliverymen, janitors and the like. Here, where men are men and “the working poor” are generally from other countries, the offer set up a political dilemma: Insure the American-born children of illegal aliens or walk away from bajillions of federal dollars? Either way, half the state would call you a sap.

Long story short, California went for it. Sorta. The easy solution would have been to use the money to let more kids have Medi-Cal, which insures the poorest citizens, but Gov. Pete Wilson didn’t want more entitlements. Instead, he routed the working poor toward the private sector, where the sap-potential apparently seemed less imminent.

From there, things seemed rosy. Then came July, when the paperwork went out to those multitudes of the working poor. They took one look at those pages of charts and decimals and questions that for all they knew might get Dad deported and opted for un-Healthy Families. For three months now, they’ve been staying away in droves.

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There isn’t much that’s equivocal about this situation. More than 6 million Californians--including 1.7-million kids--lack health insurance, and the number is rapidly growing with the rollback of AFDC. There are about 400,000 little ones out there who could be getting checkups right now via Healthy Families. Trained “assisters” are being paid to help people fill out the forms, and still only about 20,000 kids have been signed statewide.

There are lots of reasons for this to worry people, more reasons than there are emotions to mix. In a country this rich, health care should be a birthright. Also, Healthy Families is costing a ton of money. And these kids mingle with your kids on the beach, at the park--and in school, which, as any parent can tell you, is childhood’s own petri dish.

If we’re going to give them health insurance, then we should give them health insurance already, and make it as straightforward as it can be. Where to start? Do something about that application. Twenty-eight pages? Sheesh. Try two or three.

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Shawn Hubler’s column appears Mondays and Thursdays. Her e-mail address is shawn.hubler@latimes.com.