“It will be interesting to see what happens if they come up with universal coverage,” she said. “What will our role as a federally qualified health center be? … How is our role defined after that?”

What one senses is a conflict between idealism and rural reality; of course, she would like everyone covered, but there is a nagging sense that politicians who don’t understand places like this will pass major legislation that changes the funding model for health care — and clinics like the one here — and yet somehow doesn’t work as advertised.

“I worry we will have patients here who somehow do not fall into some category and somehow slip through the cracks,” is how Chouinard put it.