Deborah Llavanes is one of a growing number of middle-income Americans who, because of the recession, have lost their jobs and their health coverage. For the first time in her life, Llavanes is turning to a community health clinic for her medical needs.

At the Healthpoint Dental Clinic in Redmond, Wash., Llavanes sits in the waiting room. She’s here to get a couple of cavities filled. She discovered Healthpoint last winter when she got sick and needed a doctor.

“I am at Healthpoint because I do not have insurance coverage, and Healthpoint provides a sliding scale where, based on your income, you pay accordingly.”

At age 53, for the first time in her adult life, Llavanes is uninsured. During the height of the real estate boom, Llavanes was working as a mortgage loan officer and made as much as $7,000 a month. Today she is unemployed.

Llavanes takes advantage of the sliding fee offered by Healthpoint and ends up paying $20 for her appointment.

Dr. Kim McDermott, a pediatrician at Healthpoint, says never in her career has she seen such a demand for the sliding-fee medical care her clinic provides.

“More patients who I would consider middle class are coming, and we didn’t use to see that. We were more a safety net for the poorest families in our state,” McDermott says. “But lately I’ve seen more and more patients who had insurance and have lost it – so, a different demographic of patient than we used to see.”

Over the past year, Healthpoint reports a 27 percent jump in requests for appointments at its seven clinics in the Puget Sound region. Harder to come by are up-to-date national statistics on how the current economic crisis is swelling the ranks of the uninsured. The most recent figures – from 2007 – showed nearly 46 million Americans lacked coverage. The number of uninsured is expected to be higher when new data is released this fall.

One figure that can be tracked is visits to emergency rooms. According to the American Hospital Association, 6 in 10 hospitals report an uptick in uninsured visits to the ER.

“We began seeing our first changes as early as October and November of this past year,” says Johnese Spisso of the University of Washington Medicine. UW Medicine operates Seattle’s Harborview Medical Center, a regional trauma center.

Besides more charity cases, Spisso says UW Medicine is noticing another trend.

“One of the things we have seen is people delaying more of what we sometimes in the health care industry call ‘elective surgery,’ and it’s really not elective, it’s scheduled surgeries – so things they need to have done that are not a crisis,” Spisso says. “We’re seeing people delaying that if they’ve lost their insurance.”

More than half of the nation’s hospitals are reporting this trend.

So what’s it like to lose health insurance?

“Stressful,” says Llavanes. “I think it’s something that when you have it and have had it for a lifetime, you don’t really think about the benefits of health care until you need it.”

Llavanes is looking for work, and she says even more important than salary is whether the job comes with health benefits.