MEMPHIS, Tenn. — Jessie McClure first turned up at the Church Health Center a decade ago with a heart problem and no insurance. Today, the retired preacher says he doesn't know where he'd be without the clinic: "I'm doubtful I would be alive."

At the Church Health Center, the nation's largest faith-based, nonprofit primary-health clinic, no insurance is no problem. It has treated tens of thousands of working people without health coverage in Memphis, one of the nation's poorest big cities.

Many are employed by businesses that don't offer health benefits or that hire part-time workers who can't afford health-plan premiums.

Such clinics are trying to fill a growing gap in health-care coverage. As of 2003, the number of full-time workers who got health benefits from their employers had dropped to 60 percent.

"The cost of health care and insurance continues to go up, and more and more companies are not paying," said Bruce Jackson, executive director of the Christian Community Health Fellowship, a Chicago-based group dedicated to caring for the poor. What Memphis' Church Health Center is doing, he says, "is a model."

The number of such clinics is rising, in part, because churches are experimenting with new roles in their public ministries, including a growing focus on caring for the poor.

In Memphis, patients are treated at low cost by a small staff of doctors, dentists and nurses — including some who have accepted salary cuts of up to $70,000 to work at the clinic — and by a citywide network of more than 400 volunteer physicians who see patients in their own offices or at the clinic on evenings and weekends.

The patients' medicines are donated by drug companies and others. The clinic is funded by various organizations, including churches and business foundations. It accepts no money from the government.

It is a grass-roots response to a rapidly changing health-care landscape. About 31 million people were uninsured when the clinic opened in 1987. Today, that number is more than 45 million.

"The need for it has become unbelievably important," said Dr. G. Scott Morris, the clinic's founder and executive director. "The problem has penetrated into the middle class."

In Tennessee, health providers are bracing for even more uninsured as TennCare, the state's health program for the poor and uninsured, faces major cuts.

Morris, who also is a Methodist minister, believes his patients should get the same quality care as their more-affluent, insured counterparts. The waiting room is sunny and spacious. Toys litter the floor. Patients who call early are seen the same day.

But when it comes to payment, this operation is different. The clinic treats the working uninsured, children and the elderly.

Working-age patients must show proof of employment. Payment is based on a sliding scale, because Morris believes patients want affordable care, not a handout.

The clinic also offers training to congregations on building health ministries. In its eight years, the training has spawned at least 25 other clinics nationwide. It also offers a low-cost health plan to small businesses and the self-employed.

The clinic is ecumenical and steeped in the idea that spiritual health promotes physical health. A wellness center called Hope & Healing has a room where prayer groups gather.

Nutrition and health classes open and close with prayer. In the clinic's waiting room the verse James 5:14 is painted on the wall: "Is any one of you sick? He should call the elders of the church to pray over him."