Desperate for care, facing more cuts

As Senate vote nears, free clinic in Va. shows need for services is great

WISE, Va. — Anthony Marino, 54, reached into his car trunk to show a pair of needle-nosed pliers like the ones he used to yank out a rotting tooth.

Shirley Akers, 58, clutched a list of 20 medications she takes, before settling down to a sleepless night in the cab of a pickup truck.

Robin Neal, 40, tried to inject herself with a used-up insulin pen, but it broke, and her blood sugar began to skyrocket.

As the sun set in the mountains of southwest Virginia, hundreds of hurting souls were camped out or huddled in vehicles, eager for an early place in line when the gates swung open at 5 a.m. for the nation’s largest pop-up free clinic.

The Remote Area Medical Expedition, staged at a county fairground in Appalachia over three days ending Sunday, drew more than 2,000 people who endured high heat and long waits for basic health services. It was a dispiriting reminder that as Congress flails around for health plans that could cost millions of people their insurance, many more don’t have much or any insurance or access to medical care to lose.

Four years into the rollout of the Affordable Care Act’s major provisions, 29 million Americans still lack health insurance. Millions live in states like Virginia that did not expand Medicaid to childless adults among the working poor, as the law allowed. Even for people helped by government programs like basic Medicaid, veterans’ care and disability, there are many gaps: Low-income people struggle to afford co-payments, the gas to drive to a doctor and prescription drugs.

“Expect Delays. Heavy Traffic Area,” a sign flashed on the normally sleepy country road before the Wise County Fairgrounds.

Patients passed the command tent of