BALTIMORE — As the sun rose Saturday, Delores Connolly stood in line outside a public school here clutching a numbered ticket. Connolly, 61, who has health insurance, was waiting to enter a clinic offering free medical and dental care.
“She’s playing with me now,” Connolly said, fidgeting as a uniformed woman at the entrance to Pimlico Elementary/Middle School repeatedly called out No. 92, in English and Spanish. Connolly was No. 93. Dental care was dropped from her Medicaid coverage this year, Connolly said, and her plan would not cover eyeglasses to replace a pair she had lost. She had queued up at 5:30 a.m. at a temporary clinic operated in Baltimore over the weekend by the nonprofit Remote Area Medical (RAM).
Her number finally called, Connolly proceeded into the school, a participant in a ritual that offered a telling view of the nation’s health-care system in 2019. Nearly a decade after passage of the Affordable Care Act — which promised to overhaul that system with a dramatic expansion of coverage — Americans with and without insurance were lining up before dawn to obtain care they otherwise couldn’t afford.
“Whatever they’re offering here, I’ll grab it,” said Nelia Shipley, 65. Shipley, who has insurance, had heard about the clinic from her friend, 70-year-old Virginia Young, who also has insurance. Both were in line at the school. “We need help,” Shipley said. “That’s why we are here.”
Tennessee-based RAM was founded in 1985 as a volunteer corps of medical professionals to provide free care in underserved regions of developing countries. But the group quickly established mobile clinics in the United States, responding to the many uninsured.
Today, much of that population differs in its coverage status but not in its need. Forty-nine percent of RAM patients this year have lacked health insurance, according to figures provided by the group. A larger share, 84 percent, lacked insurance for vision or dental care, which are among the most popular services at the mobile clinics.
“If you look at someone who’s making $15,000 to $20,000 per year, and they have a $5,000 deductible — they have insurance, but they don’t have health care,” said Jeff Eastman, RAM’s chief executive. Eastman said the group, which originally focused on rural areas with high poverty rates, is increasingly operating in large cities. Some, like Baltimore, are home to top hospitals. RAM has set up clinics in Tennessee and Kentucky. But it has also delivered care in Florida and Orange County, Calif.
“Everybody thinks that health care, and lack thereof, is an Appalachian issue,” Eastman said. “But it’s across the whole United States.”
Last year, the group served more than 45,000 people.
This was RAM’s second visit to Baltimore, a city that — from presidential accusations of rodent infestation to the resignation in May of a scandalized mayor — has become a potent but often misunderstood icon of 21st-century urban America. During the first visit, in 2017, the group said, it provided more than $646,000 worth of free care to 1,140 people.
The mobile clinic, open through Sunday at the school in northwest Baltimore, is a collaboration of RAM and insurance company Aetna, which secured the site, contributed funding and organized more than 200 volunteers. Ticket distribution began at 3 a.m. Saturday, and doors opened at 6. By 9 a.m., more than 200 patients had been seen.
Shortly after 8 a.m., the school’s gymnasium — transformed into a dentistry emporium — was crowded and filled with the whine of whirring drills. Baltimore Mayor Bernard C. “Jack” Young (D) and City Council Vice President Sharon Green Middleton toured the facility. As Young recorded a video on his phone to help publicize the event, Latisha Drummond reclined in a chair behind him, enduring the final stages of a tooth scaling.
Drummond, a 28-year-old Baltimore resident, has insurance coverage through her job as a postal worker. She said her plan covers basic dental cleanings but not the more extensive work she needed after four years without seeing a dentist. During that time, she said, she had focused on dental care for her 3-year-old son, Za’Khari.
“You got to take your pick,” she said. “Pay your own bills, pay your children’s bills.”
Drummond had arrived at midnight to claim ticket No. 2. She took Za’Khari to the school playground in the dark as she and others waited for the clinic to open.
Shortly after Drummond and her son left the gym, No. 93 — Connolly — came in. She had been through intake and a basic medical screening, and now sat in the bleachers waiting for a dental chair to open. After that, she would go to her eye exam.
Connolly talked to a reporter about the minutiae of her insurance policy. While her dental coverage was gone, she said, she liked the medical component of the plan and was afraid to switch. On balance, and under the circumstances, she thought it was the best she could do. She was grateful that free care was available to fill the gaps.
Then, as a volunteer in a bright orange vest approached, hand outstretched, Connolly smiled.
“Miss,” the volunteer said, “you can come.”