Through two years at Georgetown University, Anna Landre has posted a 3.9 grade point average, completed a prestigious internship and become a columnist for the student newspaper.

The Lacey resident and former Freehold Township High School valedictorian has done all this with spinal muscular atrophy type 2, a progressive muscle weakening that requires the use of a motorized wheelchair.

It’s an amazing success story. It’s also a cautionary tale. The state of New Jersey is reducing a key part of Landre’s Medicaid, reversing a judge’s order in the process. Barring a legal Hail Mary, she won’t be able to continue at Georgetown next fall.

“This is a really scary time for me and my family,” she said.

In a nutshell: Landre’s insurance company is reducing her access to a personal care aide, despite no changes in her medical condition, by nearly 40 percent (from 16 hours per day to 10). Without an aide she can’t get in and out of bed, can’t use the bathroom, can’t receive the necessary respiratory protocol for her ailing lungs.

Watch the video at the top of the story to see more about how she lives with her disability, and check out the links below to previous stories on her fight.

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Landre can’t survive on a college campus with 14-hour daily gaps in care. She’d have to move back to New Jersey and live with her mother. That's why she appealed the original reduction notice by Horizon NJ Health, and in February administrative law judge Mary Ann Bogan ruled in her favor after hearing physician testimony.

“The reduction by Horizon is arbitrary,” Bogan wrote in her decision. “(Landre) is completely dependent on others for her day-to-day living, and Horizon has not demonstrated why a precipitous reduction is warranted.”

But Bogan's ruling came with a caveat: The chief of New Jersey’s Division of Medical Assistance and Health Services has the authority to reject or modify the decision. Last week that chief, Richard Hurd — who never has met or spoken with Landre — rejected it. He sided with the insurance company, describing the extra six hours per day as “supervision and companionship” that fell outside the scope of coverage.

“It’s really scary to think that both the state of New Jersey and my insurance company have the power to stop and start my life however they choose,” Landre said. “I physically don’t have the ability to go to college, have a career or have relationships without these services. It’s also shocking to me that a judge’s decision can simply be overturned by one bureaucrat.”

Why did this happen? As Bogan implied in her ruling, the personal care aide system was designed for the homebound. There is no provision for someone with a so-called severe disability who is living away at college. The exceptional Landre is stretching those perceived boundaries, and probably being penalized for it.

“She is excelling at school academically and personally because she has the necessary medical supports,” Landre’s attorney, Amy Quinn of the nonprofit Community Health Law Project, wrote in a court filing.

Without those supports, her future is cloudy. Landre, who has been overcoming hurdles for all of her 20 years, has smashed into a state of New Jersey roadblock.

“At this point I’m still grasping at straws to see if I can get this decision reversed,” she said. “I’m not very optimistic about that.”

Jerry Carino is news columnist for the Asbury Park Press, focusing on the Jersey Shore’s interesting people, inspiring stories and pressing issues. Contact him at jcarino@gannettnj.com.