In an effort to address soaring demand for dental services, the Iowa City Free Medical and Dental Clinic at recently completed a $1.35 million project for renovations funded by the City of Iowa City and Johnson County. 

The clinic had an 18 percent uptick during fiscal 2024, treating 6,715 patients, which is more than the 5,691 patients they treated in 2023. In their 2025 data report, the National Association of Free Charities and Clinics announced 81 percent of clinics reported an increase in demand, amounting to 6 million visits last year. 

The renovations began in December 2023 and concluded with a grand opening open house on Oct. 8.

To combat climbing numbers, the Iowa City City Council awarded a $1 million grant to the clinic through the American Rescue Plan Act, or ARPA, in March 2023. 

Johnson County awarded the remaining $350,000 through the ARPA-funded Building Nonprofit Capacity Grant Program, which sought to assist local nonprofits following the COVID-19 pandemic. 

Demand for free medical care is rising sharply, according to Jennie Schmidt, executive director of the Iowa City Free Medical and Dental Clinic.

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Schmidt said factors like new Medicaid work requirements, which require people to verify they’re working to keep coverage, and the upcoming expiration of Affordable Care Act subsidies, financial assistance from the federal government, could be the factors leaving more people uninsured, increasing demand for free medical care. Ultimately, she said, workers in the health care industry are unsure of a definitive cause.

To meet the increasing demand for services, the clinic continues to rely on local funding support, fundraising events, grants, and private donations. The clinic costs around $950,000 to operate in 2024, according to ProPublica’s Nonprofit Explorer. She said some clinics are feeling the pressure.

“The director of a clinic in Cedar Rapids said, for the first time ever this summer, that they had to turn patients away. Demand is increasing so quickly,” she said. 

Schmidt said the goal of the newly completed renovations was twofold.  

She said one goal of the renovation was to make the space more efficient to accommodate more patients, and the other was to modernize the outdated 1970s building, including upgrading the HVAC system to improve ventilation and overall health.

The upgrades also include three exam spaces in a triage room, tripling the size of the dispensary, containing prescriptions and medical supplies, increasing staff workspaces, and replacing old carpet. 

Schmidt said the new triage room is where patients are initially assessed and sorted based on the urgency of their medical condition. This will help cut down on the current three-month waitlist.

“If somebody comes in and they need their blood pressure checked, or they need an injection or something minor like that, they can just go into the triage room and not take up a whole exam room,” she said. 

Schmidt said she hopes the upgraded facility will address the facility’s waitlist for dental services by making the space more appealing for volunteers to work in. 

“When [dentists] come here, they’re not going to have the state-of-the-art equipment they might have in their offices but they have very good equipment, but we’re hoping that it’ll be more attractive to more volunteers to come and work here now that it’s been upgraded,” she said. 

The clinic has hired a dentist for two nights a week and is relaunching the volunteer program in January. She said, ideally, the clinic hopes to have four to six rotating volunteers, with dental services like fillings, extractions, and exams offered on Mondays and Thursdays.

Schmidt said dental care is a major challenge because many people lack dental insurance. According to Care Quest Institute for Oral Health, 27 percent of the nation lacks insurance and even those with Medicaid are often only able to provide low reimbursement rates for providers, discouraging dentists from accepting it.

“With dental, we have the demand of the uninsured. Many are insured, and they just can’t use their insurance because it’s going to pay back 30 to 40 cents on the dollar,” she said.

This leads to delays in care, meaning minor issues become severe, Schmidt said.

“It’s unfortunate that our dentist does a ton of extractions and fewer fillings because of the time they get to us. It’s also true that a lot of people end up in the emergency room with dental pain, which is also a shame, because all the emergency room can do is medicate it,” she said. 

Lisa Steigleder, the clinic’s development director, said the extra exam rooms allow patients to be prepped in advance, which should improve patient flow.

“Patients can be roomed and ready to go as the provider moves. So theoretically, that will improve the output of patient volume,” she said. 

She also noted the renovated, modernized space will make the clinic’s appeal extend past volunteers. 

“It also will help with donors and sponsorships and the support coming into assistance to the clinic as it’s really been modernized quite a bit,” Steigler said. 

Rohit Nair, associate professor in the University of Iowa’s College of Dentistry, explained dental coverage is limited for many adults, particularly part-time workers and older adults on Medicare, which doesn’t cover dental benefits. 

According to the Centers for Medicaid and Medicare Services, Medicare does not cover standard fillings, removal, replacement, or dental care, including routine dental visits.

“All of that starts painting a picture of significant dental needs in the community,” he said. “Although the cost of dental care isn’t as high as medical care, when you consider that a lot of people don’t have insurance to help cover dental care, the out-of-pocket costs start adding up significantly, and so that forms a major barrier.”

Nair said tearing down such barriers requires multiple approaches. 

“Better reimbursement may translate into better access for a lot of individuals, because then more providers will be willing to serve these patients,” he said. 

Nair also said additional training for dentists and policies that support preventive care, especially as children transition into adulthood, could further help meet community dental needs.

Schmidt explained while the clinic can’t change policy overnight, the renovations make them more well-positioned to meet a growing demand for care.

“We hope that we’re poised for another 20 years, if not more. Unlike most businesses, our dream would be to go out of business,” she said. “Our vision is to live in a world where there are no barriers  to health care.”