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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

In the Ozarks, a Free Clinic that Wants to Go out of Business

Sebastián Martínez Valdivia
Terry Cox waits to see a dentist at the Good Samaritan Care Clinic in Mountain View, Missouri.

On a chilly afternoon, Terry Cox had come to Mountain View, Missouri, to see a dentist and was waiting on a bench outside a converted rectory.

“Came to get a tooth check and see what they got to do to it," Cox said. "Maybe get ‘em all out."

The 56-year-old works in northern Arkansas, and drove an hour and a half to the Good Samaritan Care Clinic.

Trucks hauling timber out of the Ozarks flew by on Route 60, which runs right through the town of 2,700. The clinic sits next to the First Baptist Church, which donated the building. It’s open once a week, and – the big draw for Cox – it’s free.

“It’s a big relief, compared to a big bill. I’ve got a lot of them," Cox said. "Thank god that they’ve got places like this ‘cause it helps out the poor people, it really does."

Credit Sebastián Martínez Valdivia / KBIA
The Good Samaritan Care Clinic sits on a lot next to the First Baptist Church, which donated the building.

Cox was not alone. Around 5 PM the door opened and dozens of patients filed into the waiting room, where they were given forms to fill out before treatment started at 7. The clinic will see everyone who’s in the waiting room at that time – usually from 35 to 50 patients..

Sheri Noble is the clinic administrator and the only full-time employee. "“We see a lot of middle age men and women who have gone without care for a long time," she explained.

She coordinates volunteers – often doctors and nurses who drive some 100 miles from Springfield after working full days at their own practices. Noble said they’ve seen a rising number of patients over the last couple of years. 

That coincides with another troubling trend. In 2018, more than 27 million Americans went without insurance for the entire year, the Census Bureau says. That was an increase of almost 2 million from the year before.

Experts point to a number of factors, including President Trump’s moves to undermine the Affordable Care Act. Medicaid restrictions are a factor as well. More than 90,000 children have lost Medicaid coverage over the past year and a half in Missouri alone. 

Joan Alker heads the Center for Children and Families at Georgetown University. According to her research, "states are putting more red tape on families who are trying to enroll their families in Medicaid, or making it harder for them to renew and extend their Medicaid coverage.”

The center's research shows Missouri has seen one of the biggest increases in uninsured children in the country. The state is one of 14 that haven’t expanded Medicaid under the Affordable are Act.

Credit Sebastián Martínez Valdivia / KBIA
Maxine Horgan, a volunteer dental assistant, collects signatures outside the clinic for a Medicaid expansion ballot initiative.

“If Missouri were to expand Medicaid to parents and other adults, you’d see a welcome mat for the children, and that uninsured rate would come down,” Alker said.

Alker says free clinics like the one in Mountain View can be stopgaps for families without insurance. But they’re not a sustainable resource for children.

Dr. John Roberts, who founded the clinic 15 years ago, agrees.

“In an ideal world we’d be put out of business, truly," Roberts said. "There would be a health plan for everybody."

That’s why he supports an initiative to get Medicaid expansion on the ballot in Missouri. The Republican-run legislature has rejected expansion there, but ballot initiatives have succeeded in other GOP-controlled states, like Idaho and Utah.

Outside the clinic, a volunteer was collecting signatures to get the issue in front of voters in 2021. If the initiative succeeds, an estimated 200,000 people could be eligible for medical insurance.

For. Roberts, that could mean fewer patients at his clinic – something he said he would welcome. “They wouldn’t have to wait in line for three or four hours on a Monday night in the heat of the summer, the cold of the winter, hoping that they will be seen."

Missouri Health Care for All announced in September it had gathered 25 percent of the 172,000 signatures it needs. The deadline is May 3.

Sebastián Martínez Valdivia is a health reporter and documentary filmmaker who focuses on access to care in rural and immigrant communities. A native Spanish speaker and lifelong Missouri resident, Sebastián is interested in the often overlooked and under-covered world of immigrant life in the rural midwest. He has a bachelor's degree in broadcast journalism from the University of Missouri and a master's degree in documentary journalism at the same institution. Aside from public health, his other interests include conservation, climate change and ecology.
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