Georgetown University student, Advisory Neighborhood Commissioner, and disabled rights activist Anna Landre may be unable to return for her junior year in the fall, due to an ongoing legal dispute with her health insurance provider.

“There are these endless barriers put up against all of the normal life milestones that non-disabled people, people that don’t need help with their activities of daily living, just take for granted,” Landre tells DCist.

Landre, who uses a power chair and requires daily help from personal care aides, says she learned Tuesday that the Medicaid office in her home state of New Jersey would approve the decision by her health insurer, Horizon NJ Health, to reduce her coverage from 16 hours of care per day to 10, despite no change in her health status.

The decision “was really unexpected and we’re still kind of unclear on why” it was made, Landre says.

The reduced coverage would jeopardize Landre’s daily life in D.C. (So far, her 16 daily hours of care have so far remained unchanged throughout the legal proceedings.) Landre needs overnight care in the event of an emergency—which amounts to roughly eight hours—and also relies on health aides for help with showering and dressing herself, using the bathroom throughout the day, and administering medical treatments. Landre says the reduced coverage would hardly be enough to provide her with the full scope of care she needs, and is considering moving home to New Jersey and relying on family members for support.

“At this point, my family and I are talking about what will happen if my mom has to quit her job to stay home and take care of me,” she tweeted.

Landre’s legal contest with Horizon NJ Health has been brewing since January, when Landre’s legal team appealed the original reduction notice. According to the Ashbury Park Press, the judge in that hearing ruled in favor of Landre but noted that the chief of New Jersey’s Division of Medical Assistance and Health Services had the authority to reject or modify the decision. Landre’s lawyer learned this week that the judge’s decision had been rejected.

Horizon Health would not comment specifically on Landre’s case, due to privacy laws, but said in a statement that “as a Medicaid managed care organization, Horizon New Jersey Health administers the Medicaid program according to rules set by the federal and state agencies that fund Medicaid. Horizon does not establish Medicaid eligibility criteria for any member nor does it determine benefits available to members. Rather, HNJH is required to follow the protocols and rules established by the program’s federal and state administrators.”

Landre and her lawyer plan to appeal the decision in the Appellate Division of the New Jersey Superior Court, but it’s a process that may take years. In the meantime, Landre is seeking a continuation of benefits, which would allow her to keep receiving care until the court reaches a decision.

“If I’m able to get a continuation of benefits, I’ll definitely stay at Georgetown and continue my life as it was before—of course, with this huge storm cloud hanging over my head,” she says.

A spokesperson for Georgetown University said the school is working with Landre directly “to explore all options for support.”

Landre hopes to funnel her struggle into broader advocacy for disabled people in D.C. and New Jersey. In her first term as an ANC commissioner, she has worked to make historic preservation projects along the Georgetown Canal accessible for disabled visitors. She sees healthcare as another sphere to tackle.

“These programs aren’t made for disabled people to be people,” she said of the coverage she’s received under New Jersey’s Medicaid policies. “They’re made for us to be homebound and be sick all the time, and to get the bare minimum of care so that we basically can stay alive, but with very little quality of life.”