A uniquely american response to the coverage gaps created by the american approach to healthcare Americas health care delivery system is complicated, expensive, fragmented, and inequitable. These characteristics have contributed to sizable and intractable uninsured and _under_insured problems. In 2021, an estimated 8.6% of the U.S. population lacked health insurance. Though reaching a historic low, the number of uninsured exceeded 27 million. Furthermore, this overall rate masks racial and ethnic disparities: 9.6% of Black residents and 17.7% of Latino residents lacked health insurance versus 5.7% of Whites. For nonelderly adults 19-64, 13.5% of Black residents and 24.6% of Latino residents lacked health insurance, compared with 8.2% of Whites. Among adults with incomes below 100% of the federal poverty level ($26,500 for a family of 4), 24.0% had no health insurance. In addition to the millions of U.S. residents without any health insurance, an estimated 23% of U.S. adults were _under_insured, defined as having inadequate health insurance coverage that did not provide them with affordable access to health care. This session aims to increase knowledge about free and charitable clinics, which are lesser known – yet vital – members of the U.S. health care safety net that seek to serve uninsured and underinsured persons. Free and charitable clinics are private, nonprofit organizations that utilize volunteer licensed healthcare professionals to deliver a range of services (medical, dental, mental and behavioral health) at no cost or for a small fee to patients who are uninsured and underinsured and disproportionately members of racial and ethnic minority groups. Collectively, the estimated 1,400 known free and charitable clinics in the U.S. annually reach approximately 2 million patients and provide between 4 to 5 million medical and dental visits. Leveraging the disparate backgrounds of the three presenters who represent academia, a national membership association serving more than 800 free and charitable clinics, and a national humanitarian aid organization that is an important resource to free and charitable clinics, this session will share the latest scientific research, discuss the relevant policies affecting this unique sector, and highlight innovative programs that demonstrate free and charitable clinics’ unique gap-filling role in the safety net and showcase how they provide high-quality care to the most marginalized populations in the United States. During the session, the presenters will feature an innovative national program that they jointly co-lead, called “Roadmap to Health Equity.” Launched in 2017, it has involved more than 150 free and charitable clinic stakeholders, including state-level associations serving free and charitable clinics and clinic leaders across the U.S., with the shared goal of improving the quality of care and reducing inequities. Its centerpiece is a custom national data repository of 15 validated clinical quality measures, such as blood pressure control, and patient-level characteristics, including age, race, ethnicity, and language. The repository makes available stratified performance data on the clinical quality outcomes. Focusing attention on these little known, yet critical, members of the U.S. safety net that serve patients who might otherwise fall through the cracks offers tremendous potential for rich interactions with a diverse audience from around the globe about community-level strategies that advance equity.