By By Petula Dvorak, The Washington Post

Rhonda Gibson tries to crack a smile with an ice pack on her face after she got a tooth pulled and was still feeling some pain. She's from Coeburn, Va. and has no dental insurance. (Michael S. Williamson/The Washington Post)

Rhonda Gibson tries to crack a smile with an ice pack on her face after she got a tooth pulled and was still feeling some pain. She’s from Coeburn, Va. and has no dental insurance. (Michael S. Williamson/The Washington Post)

A gravel parking lot deep in the green hills of Virginia coal country was packed to capacity by 4 a.m. Friday. More than 1,500 people with canes, wheelchairs, oxygen tanks, bleeding gums, black lungs and other ills had come to the Wise County Fairgrounds, camping in tents, sleeping in pickup truck beds or scrunched up in their cars, hoping to see a doctor.

At midnight before the clinic opened, there were 1,204 people in line. And over the weekend, thousands more will come.

Like a third-world country, this is what health care looks like for many of the folks in this corner of southwest Virginia. And it will keep looking like this, thanks to state lawmakers who could have helped their most desperate constituents but instead blocked, bickered and weaseled until Virginia forfeited billions in Medicaid expansion funds. The result: More than 400,000 people who would have qualified for Medicaid coverage will continue to go uninsured.

This was hard for some of the people gathered here to stomach. They wish they could afford to go to a real doctor’s office to get their blood checked or their rashes examined rather than the cow stalls and tents of this free clinic. The Remote Area Medical clinic sets up here every year, with volunteers providing free dental, eye and medical care to those in need.