N.H. Debates Insurance Guarantees for Students on Medical Leave

Before colon cancer took her life, Michelle Morse tried not to let it take over.

"I just don't want to be known as 'the cancer girl!"' she wrote in her journal last April. "It's just not me."

The aspiring teacher continued to attend Plymouth State University full-time during her illness, often wearing a chemotherapy pump on her hip to class or when she did her student teaching at a Manchester elementary school.

But by the time she died in November, Morse, 22, had become a reluctant celebrity, lending her name and support to a bill aimed at sparing others at least one of the agonizing decisions she faced: whether or not to stay in school.

Though her doctors recommended she reduce her courseload, Morse maintained her full-time schedule in order to keep her health insurance. She was covered under her mother's plan, which required her to be a full-time student or to pay about $550 a month to remain covered.

She talked about her feelings in a journal that her family allowed The Associated Press to read.

"I'm scared for my mom and dad," she wrote in December 2003, just after she was diagnosed. "I want to make this easier on them."

Michelle's mother, AnnMarie, has become the driving force to enact "Michelle's Law." The bill would require health insurance companies that cover college students under their parents' plans to continue the coverage if a student takes a medical leave of absence.

"I have a lot of energy," AnnMarie Morse said in a recent interview. "I knew the odds were against us ... but I knew I had to do something else because not only did I have my two children in college, but every other college child became my child."

A House committee unanimously recommended the bill last month, and the House will vote on it next month.

Other states, meanwhile, have taken a broader approach by allowing young adults to remain on their parents' plans longer regardless of whether they are in college.

Those laws are aimed at addressing the nation's fastest growing uninsured population: young people ages 18 to 24, said Laura Tobler, a health policy analyst at the National Conference of State Legislatures.

Children typically lose health care coverage under their parents' plans when they turn 19, though full-time students often are given an exception. But at least 12 states have considered or enacted laws broadening the definition of dependents in the last year, Tobler said.

In Utah, for example, dependents are covered until their 26th birthdays, regardless of whether they are enrolled in school. Starting Jan. 1, Colorado residents up to age 25 can be covered under their parents' plans as long as they are unmarried, financially dependent on their parents or living with them.

New York, which already has a law like the one proposed in New Hampshire, is considering raising the maximum age for dependents from 23 to 25. A New Jersey bill would allow dependents up to age 30 to remain on their parents' plans, though companies could charge more for such coverage.

The industry generally hasn't opposed such changes because, aside from expensive cases like Michelle Morse's, carriers are getting paid higher family-plan premiums to cover the healthiest segment of the population, said Rep. Will Infantine, R-Manchester, an insurance agent who sponsored the New Hampshire bill.

"Demographically, this is a profitable part of their business," he said.

Some lawmakers initially opposed any new mandate on insurers, he said, but came around because the bill applies only to carriers that already offer family plans. Insurance companies estimate that at most, six students a year would be affected by the bill.

"You buy health insurance to take care of you when something happens," said Infantine, whose father died of colon cancer. "To buy into a contract and then get hurt and have it terminate is not really not what insurance is supposed to be about."

Rep. Lee Quandt, R-Exeter, said some viewed the bill as elitist because it would help only people who could afford to send their children to college.

"I met Michelle and she is not an elitist kid," Quandt said.

Michelle was having surgery for what doctors believed was a twisted ovary when they discovered she had advanced colon cancer.

"I want to live a long life so badly," she wrote on Christmas Eve 2003. "I want to have a family, many Christmases and outlive my parents. I am always afraid that I may not be able to do any of that. I have learned to live each day to the fullest and go to bed happy each night."

Though she believed she would go into remission, there were dark moments.

"For the first time I actually cried by myself," she wrote in January 2004. "I am just so frustrated. Why does this have to happen to me? It's not fair. I don't know how much more my family and I can handle. This should not happen to anyone. Why can't anyone find a cure for this? Why is everyone dying and no one can find a cure to save people. Why is God even doing this to people? Why is he making families suffer? Why is he taking innocent, loving people with families and everything going for them?"

Quandt, whose son Matthew serves on the House Commerce Committee with him, said Michelle, her parents and his own four children were on his mind as the panel wrestled with the bill.

"I often thought how much I admired the mother to have the strength to continue this fight," he said. "Matthew and I decided that as long as she had the strength, so would we."

Even if the bill becomes law, AnnMarie Morse said she won't consider her job finished. She plans to push for changes in federal law that will apply to employers with self-funded insurance plans, including the school district where she works.

"I'm like a mama bear protecting her cubs. It's just wrong," she said. "It's so wrong."

In her last journal entry, written in April, Michelle Morse described finding out that her cancer had spread and that she faced a new regimen of chemotherapy.

"It came back," she wrote. "Yet, I am a different person this time. I'm more positive and I think of myself as less of a cancer patient."

"I only think about it during chemo days," she wrote. "Then I move on."