It’s not every day that 20-somethings in pickup trucks scream obscenities at a handful of retirees holding signs.

That was the scene twice Tuesday at the intersection of State Highway 20 and Main Street in Coupeville.

As the first sped through the intersection screamed, “[expletive] you,” at the protesters, who held signs saying things like “Stop Trumpcare,” and “Healthcare is a human right.”

The second stopped at the traffic light and yelled, “Work for your [expletive] money,” repeatedly.

Over the course of 24 hours, approximately 50 members of the citizen group Indivisible Whidbey staged a protest between WhidbeyHealth Medical Center and Highway 20.

Larry Behrendt, leader of Indivisible Whidbey, said the group organized the protest in response to the federal American Health Care Act, which passed in the United States House of Representatives. The act, intended to replace Obamacare, would dial back Medicaid subsidies by hundreds of billions of dollars, opponents of the measure say.

When the Senate received the legislation, it opted to draft behind closed doors its own replacement bill, which was released on Thursday. The Senate’s version of the bill also includes cuts to Medicaid.

Medicaid was expanded under Obamacare.

It’s the proposed Medicaid cuts that Behrendt said he and the other protesters most vehemently oppose.

“The Medicaid expansion in particular provided a new source of funding for the hospital,” Behrendt said. “The removal of that source of income could be devastating to our rural hospital.”

Ron Wallin, president of the Whidbey Health Board of Commissioners, said he was aware of the protesters and sympathizes with their concerns, but said he hopes that federal lawmakers figure out a way to watch out for the little guy.

“You would hope, and think, our politicians could work together to find a workable solution,” Wallin said. “I feel that the (AHCA) needs work as most new things do, but to put so many people and rural hospitals in jeopardy is wrong.

“They all need to work for the better good of the people and not politics,” he said. “As a small rural hospital, the actions of (Washington) D.C. scare me — with all the uncertainties, they need to get it right.”

Each year, WhidbeyHealth eats millions of dollars in unpaid dollars for care.

Last year alone, the public hospital was left with $1.9 million in uncompensated care, a figure measured, in part, by clients’ “bad debt” and “charity care given,” according to Ronald Telles, chief financial officer of WhidbeyHealth.

In 2016, the hospital absorbed $869,000 in the bad debt category and $965,000 in charity, he said.

Without the Medicaid reimbursements at least maintained at current levels, Behrendt said, WhidbeyHealth’s unpaid bills would skyrocket.

As it stands, hospital personnel are doing everything they can to enroll patients in Medicaid for that reason.

Twenty percent of WhidbeyHealth’s patients are on Medicaid, Telles said.

A total of 1,426 of those patients enrolled in Medicaid since 2014, according to Patricia Duff, community relations and marketing coordinator for WhidbeyHealth.

Behrendt said he fears for the hospital’s future.

“I’m concerned that the only hospital on Whidbey Island would have to shut down or scale back due to Medicaid cuts,” he said, adding that he doesn’t want to think about what that could mean for some people.

Behrendt’s fears aren’t without basis — 79 rural hospitals have closed since 2010 alone, according to the North Carolina Rural Health Research Program, a policy and analysis center in Chapel Hill, N.C. The hospitals shut down due to a variety of reasons, but Behrendt said the protesters didn’t want the hospital to become one of those statistics because of Medicaid cuts.

Island County Commissioner Rick Hannold, chair of the Board of Island County Commissioners, said he appreciated the level of respect the protesters showed the community. However, he said they were demonstrating against legislation that is incomplete and thus unknown.

“How it will or will not affect our business is a total unknown, therefore I will be pleased when the discussions and debates at the federal level are done and a decision is made,” Hannold said. “The hardest matter to deal with in any agency is knowing that something is certain to change, but the unknown is difficult to deal with or prepare for.”

Clinton resident Malcolm Cumming, an active member of Indivisible Whidbey, said the local group is working in concert with 500 similar groups in every congressional district in the country.

For Cumming, it’s personal. In 2012, he received a liver transplant, thanks to the Affordable Care Act.

“The goal of Indivisible is to hold our members of Congress’ feet to the fire,” Cumming said. “If they are supportive, we try to support them.”

Otherwise, it’s to the streets.

Clinton resident Malcolm Cummings displays a sign meant to spread awareness of the potential consequences of Trumpcare as part of a protest vigil Tuesday in Coupeville. Turn to page A12 of today’s Whidbey News-Times for the full story.