The little group met up outside Rep. Tom MacArthur's district office in Marlton just before 11 a.m. Health care was back on the national political agenda — in an unwelcome way, in their opinion — and these constituents of the Republican congressman from Burlington and Ocean Counties were back on resistance.

Here is how one small skirmish in the political trench warfare over the issue unfolded Wednesday:

MacArthur, whose amendment earlier this year almost succeeded in derailing the Affordable Care Act, has yet to come out for or against the latest GOP proposal to repeal and replace the health law, but the five Burlington County activists from his district were taking no chances.

Back in May they were among the hundreds who confronted the congressman at a town-hall meeting in Willingboro.

On Wednesday, they came bearing a letter demanding that he oppose the Senate proposal if it makes it to the House.

The plan by the advocacy group New Jersey Citizen Action was to send waves of activists to the district offices of GOP members of Congress across New Jersey with similar petitions through the day.

Before going into the Gibson House community center, where MacArthur's district office is located, Eileen G. Hill, 63, of Mount Laurel, a retired physician and coordinator of the SJNOW Indivisible group, steeled herself for a "hostile" reception. She and the others said they had been through the routine before.

"They have been less and less kind since January," she said. That's when Donald Trump was elected president, prompting Hill and the others — all of whom identified themselves as either Democrats or independents — to join resistance groups such as Indivisible.

They had made no appointment, and once inside, someone advised them to wait for a representative to come down from an upstairs office.

Upstairs, the young staffers seemed wary, but not hostile. One directed a reporter to contact one of her superiors in Washington.

Minutes passed, and no one came down.

So up went Marty Weinar, 68, of Moorestown, a retired nurse and former executive at a hospital chain.

At the top of the steps she approached Kyle Melander, constituent services representative for MacArthur.

Can I read a letter to the congressman? she asked. He must have said yes, because she proceeded to read out the missive. The GOP's latest health-care initiative, she read, was "reckless behavior and not in the interest of the country."

Then she handed over the letter to Melander, and the group left.

Weinar gave MacArthur credit for staying as long as it took at that Willingboro town hall, but said he had dodged questions then.

As for MacArthur, a spokeswoman said later he "will fully assess the latest health care legislation when it reaches the House of Representatives. He remains committed to fixing a broken healthcare system in order to provide quality affordable care."

And, she added, "Congressman MacArthur genuinely appreciates the thoughts of his constituents on every issue under the sun. While far-left, big-money special interest groups like New Jersey Citizen Action are continuing their … divisive scare tactics, Congressman MacArthur is focused on bipartisan solutions to strengthen Joint Base McGuire-Dix-Lakehurst, help families face the opioid epidemic in our region, and grow our economy."

The activists did find an ally they might not have expected. Republican Gov. Christie came out against the latest repeal-and-replace proposal. "I can't support a bill that takes $3.9 billion away from the people of the state of New Jersey," he said.