Jennifer Morse puts the ingredients for pizza dough into the KitchenAid and turns it on, then she gets out the "Getting Better Book."
"We call it the Getting Better Book' because we're getting better," she says, standing at the kitchen counter and flipping the cover of the scrapbook to the first page. It shows her tan Toyota Camry station wagon, the right side smashed at 45 miles per hour as she made a left turn at dusk from 19th Avenue onto Northern on a Tuesday in late November 2002, not far from the west Phoenix home she shares with her husband, Jonathan, and their two kids. Jennifer had just picked up the kids from her mother's house; the family was planning to watch Ice Age that night.
Morse turns the page, to photos of her children. Both Alexis, 6, and Michael, 14, almost died that evening.
Alexis' broken right leg put her in a neon pink cast from hip to toe, but it's her face that required five hours of surgery; the right half was ripped off, glass embedded so deeply in Alexis' cheekbone that the doctors couldn't get it all out. She almost lost an eye.
Michael was in a coma for almost two weeks. He had a brain injury and a skull fracture. He had broken teeth, his nose was broken in several places and he had a chipped vertebra in his neck. He had a broken collarbone, multiple broken ribs, lung punctures and a collapsed lung. He had bruising on his liver, pancreas and kidneys.
Jennifer had a concussion, but she wouldn't let doctors treat it for hours, she was so distraught over her children.
From the moment she got out of her totaled car, Morse recalls, she panicked that her health insurance wouldn't cover the kids' medical care. She was wrong. United Health Care paid its share.
But Morse was right to worry. The hospitals wanted more. Under Arizona law, if you are in a car accident and receive a settlement from your automobile insurance, in many cases the hospital gets first dibs on that money -- even if you have health insurance.
Alexis was still in a wheelchair, sipping meals through a straw, when a lien for more than $50,000 arrived in the mail, addressed to the 6-year-old. Jennifer found that especially creepy. Hospitals contract with insurance companies to provide care at a reduced, bulk rate. But the hospitals can charge patients for the difference between that reduced rate and their regular rate, if there is settlement money available from a car accident. That's where the lien comes in. State law allows for liens that apply to auto insurance settlements, but not to personal credit or property. Arizona is not unique. Most states have similar laws.
Jennifer flips a few more pages of the "Getting Better Book." Alexis' stitches come out, the raw red cuts heal to faint scars. Michael's neck brace comes off. He smiles shyly for the camera.
The Morses' wounds are mending slowly. The bills have piled up much faster.
After more than a year of negotiations, the Morses will soon get their auto settlement money -- minus a cut for the hospitals, and the hospitals' lawyer. To Jennifer, this amounts to nothing short of double-billing. It's too late for her family to avoid it, but that hasn't stopped Jennifer Morse from launching a crusade to get the law changed and keep millions of dollars in the pockets of auto accident victims, particularly children.
As the latest legislative session gets started this week, it looks like Jennifer might just get her way.
Jennifer Morse is more qualified than most moms to get a law changed. She is a staff attorney at the Arizona Center for Disability Law, where she has worked, among other things, to get funding for mentally ill children. (The center takes no position on her hospital billing crusade, which Morse is undertaking on her own time.) Before that, she worked for the Arizona attorney general, representing Child Protective Services. And before that, she was a special advocate, assigned to kids in state care. (Jonathan recently got his engineering degree at Arizona State University.)
Morse is crafty. Her kitchen counter is stacked with terra cotta pots painted in bright colors, a large one mosaiced with blue and green marbles and tile shards. The "Getting Better Book" has four whimsical paper dolls pasted on the front, representing the four members of her family. Art and writing (see accompanying piece) are obviously a part of her personal therapy.
So is fighting a good fight. When Jennifer and Jonathan finally figured out what was going on, that the hospitals had the right, under Arizona law, to put liens on their children's auto insurance settlements, Jennifer knew who to call. Deb Gullett, a Republican member of the Arizona House of Representatives, chairs the House Health Committee. Before she ran for the House, Gullett served for years as a top aide to U.S. Senator John McCain.
Gullett is a woman who gets her way. Gullett told Morse she would help her change the law -- although the lawmaker made it clear, Morse says, that she could not help her with her family's own ongoing situation.
Morse was pleased. She started drafting her own suggested changes to the law, and unlike most constituents off the streets, even offered compromises up front. For example, she suggested that if everyone couldn't be included in a law prohibiting hospitals from placing liens on auto insurance settlements, what about just exempting children? Or what about exempting only people whose settlements are less than $200,000? (The Morses' policy offered $30,000 in coverage for each child. Jennifer Morse says she can't discuss the details because the settlement with the hospital is still pending.)
On Monday, the first day of the legislative session, Gullett said she does plan to introduce a bill in the next two weeks. She tells New Times she can't discuss specifics, because the details haven't been hammered out completely. The lien laws are very complicated, and in order to get the change Jennifer Morse wants, Gullett might have to agree to tweak the law in other places. She does not want to discuss details there, either.
"What happened to Jennifer and her family is a tragedy," Gullett says, adding that, if passed, her bill would eliminate the problem for someone in the Morses' situation. "It would make sure it wouldn't happen to anybody else. That's our intention, to do it that way."
Gullett estimates that hospitals file about $25 million in liens each year. Her bill, which would address settlements made in cases involving underinsured/uninsured policies, would affect $3 million to $5 million of that overall figure.
She says there will be another stakeholders' meeting next week.
Morse has had an obvious impact on the process -- not just by instigating the process as a knowledgeable attorney, but through the sheer power of her family's horror story. It is hard to say if the stakeholders in this process -- most notably, the hospitals -- would have gathered at the table so eagerly, without that element.
Andy Gordon, an attorney who represents the Arizona Hospital and Health Care Association, says he has met with Gullett and Morse and others interested in the process.
"I think we're going to work with Representative Gullett on the bill. She wants to limit the lien rights. . . . We'll probably work with her on that," Gordon says.
JoJene Mills, president of the Arizona Trial Lawyers Association, is a much more eager participant in the law-changing process.
"There needs to be some reform," she says. "We think if a hospital agrees to accept a certain amount of money from an HMO, then that's what they should get. . . . If a person has insurance and the hospital makes a contract with the company to accept payment for the services, then they shouldn't get any more.
"That contract is what should govern."
Jennifer and Jonathan Morse are thrilled with their choice of car seat -- Alexis' Graco booster saved her life, they believe -- but say they'd do a lot of other things differently, if given a second chance. They would not buy underinsured/uninsured auto coverage -- at least, not if the law doesn't change.
As it turned out, they needed that insurance. The woman who hit Jennifer was not insured. Her most serious injury was a smashed lip, and she complained of a few aches and pains. She was driving her Bronco with her left leg that evening, she told police, because she'd injured her right leg in a domestic incident. She had painkillers in her purse. She says she didn't realize the light had turned red. She left the hospital and no one ever saw her again.
Because of the liens, the Morses still haven't seen a penny of the settlement money from their underinsured/uninsured policy, although they certainly could use some cash. Jennifer took six months off work to take care of the kids. Immediate expenses piled up: Michael needed a special bed, a shower chair, rehabilitation equipment, even new clothes that he could put on and take off himself. The kids had constant doctor appointments, and the co-pays added up to more than $100 a week. The Morses had an insurance policy with an 80/20 percent split.
And then there are the future, unforeseen costs. Michael has a brain injury, and while he has made great improvement, his parents don't know what sort of care he'll need as the years go by. Alexis will almost certainly need extensive plastic surgery.
Last week, during a shopping trip to Costco, Jonathan looked down and noticed a shard of glass sticking out of Alexis' cheek. That happens, from time to time. Jonathan was only alarmed, he says, because he worries that one day a piece will fall in her eye. It took so much to save that eye, he recalls.
There will be less money available for care for his kids now, which worries Jonathan Morse. "We did everything as right as we could afford to," he says of his family's health and auto insurance policies. "We were wrong. That money was not ours."
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