"My husband is at home, and home is where he will stay, until I don't have a job and anything else to sell."

How to say 'I love you'

Dr. Karen Williams, a specialist in physical medication and rehabilitation, tells this story about Andy's progress during the past two years.

"The first time I saw him do something purposeful was right before we took him home. Terry told me Andy could lift his thumb. I didn't believe it. She told him, 'Come on, Andy, pick up your thumb for Dr. Williams.' We waited and waited, but nothing happened. 'Come on, Andy,' she kept saying, but he didn't move. I started to feel bad for her, and I was just about to say, 'Let's not push him, Terry,' when suddenly, up went the thumb."

The anecdote illustrates how difficult it can be to assess the progress of people who have suffered injury to the brain, Williams said.

"Has there been significant progress? By my standards, yes. People make baby steps after this type of injury - not leaps and bounds.

"We have evidence he is aware of some things, but it's inconsistent. How much he is comprehending, we don't know," Williams said.

Behind his passive face, Williams said, Andy could be crying out. "That's something we may never know. My heart goes out to Terry... but if it wasn't for her, her husband would be in a nursing home somewhere, or maybe dead from an infection."

"When he came home he couldn't say anything at all," Terry said. "But in the last two weeks he's said a lot of things. He said 'banana, vanilla and rum.' We figure he wants a banana daiquiri.'

That's a long way from saying "I love you," Terry said, but that doesn't mean he can't send the message.

Three blinks means "I love you," she said, "and sometimes he even puckers up for a kiss."

Terry's determination has caught the attention of several members of Congress, among

Petersburg and Florida Sens. Bob Graham and Connie Mack.

A flurry of letters have been written, but to no avail. Young has petitioned the Department of Health and Human Services for a review of the Cox case but has not received a response. He also has asked the Department of Defense to determine how many veterans find themselves in a similar plight, and to calculate what it would cost to keep them on CHAMPUS coverage. The agency has not responded.

CHAMPUS and Medicare once provided comparable coverage, but no longer, according to a Washington-based group that lobbies for military families.

"A number of military families are in for a shock" when medical coverage shifts from CHAMPUS to Medicare at age 65, said Sydney Hickey, associate director of the National Military Family Association.

"It's not uniquely a military problem," she said. "Medicare benefits in general are not as good as CHAMPUS benefits, or the nefits included in any plan oftered by most any employer."

The shock is especially sharp for many military families, Hickey said, "because we're taught from the beginning that we'll be taken care of. It's more than just the dollars. It's a feeling of abandonment.

Friends of the Cox_family haven't abandoned them. They've established a trust fund for donations at the Citizens and Southern National Bank of Florida.

But to Terry Cox, the issue seems simple. Andy earned the health care, got it and was benefiting from it. Then it was taken away.

Wallace, the family physician, agrees.

"It's sad. You start to see improvement, then the rug is pulled because of some bureaucratic nonsense. He should never have been pulled off CHAMPUS. She's not asking for anything more than what he needs. So why can't there be an exception?

"Terry and her mother have made tremendous sacrifices. I wonder how many other people are out there, like Andy, without

WEDNESDAY, JUNE 26, 1991 A17

The first bill arrived a week before Christmas and told Terry Cox that she and her quadriplegic husband, an Army veteran, owed the federal government $144,000. The second bill arrived in January. It asked for another $4,500.

Cox, a travel agent in St. Petersburg, Fla., was stunned. When she married Andy Cox four years earlier, he assured her: "You'll never have to worry about me. I'm retired military. They'll take care of me."

But with her husband permanently disabled by a fall and requiring round-the-clock nursing, the Pentagon's $3.2 billion insurance program covering military families and retirees to age 65 was demanding payment.

Cox, 54, who had spent 22 years on active duty before he left the Army in 1977, was the victim of a little-known gap in the Pentagon's giant Civilian Health and Medical Program of the Uniformed Services, the insurance plan known to its 9.2 million beneficiaries by the acronym CHAMPUS.

Because his disability qualified him for Medicare coverage, the Defense Department declared he was no longer eligible for the broader protection offered under CHAMPUS. And, because he was under age 65, Cox did not qualify for any of the commercial "medigap" policies that could have helped make up the difference.

"A government Catch-22," was the way Terry Cox described her plight. "I couldn't believe it and I panicked."

Her initial protests had little impact. But after months of arguing, and declaring herself bankrupt in the process, Cox may be on the verge of closing a loophole that the Pentagon says affects 37,300 disabled CHAMPUS beneficiaries.

Rep. C.W. Bill Young (R-Fla.), a member of the Appropriations Committee, recently added $20 million to care for disabled service personnel to a defense appropriatious bill that passed the House. Sen. Daniel K. Inouye (D-Hawaii) has sponsored even more sweeping relief legislation in the Senate. Both appropriation and authorizing legislation are needed before the issue can be resolved, but Cox and her

By JAMES MARTINEZ
Associated Press

ST. PETERSBURG Armed
with only a typewriter and a tele-
phone, Terry Cox took on Congress
and closed loophole that left her
husband and thousands of other dis-
abled veterans without military
health coverage.

"I would never have thought that
one person could make a differ-
ence," Cox said. "But I've always
believed that if you're going to moan
and groan about something, you'd
better not do it from the sidelines."
It took more than a year of writ-
ing, calling and pestering every
member of Congress before winning
passage of a massive military spend-
ing bill with language that perma-
nently plugs the loophole and
restores military insurance benefits
through age 65 to about 9,100 disa-
bled vets.

President Bush signed the mea-
sure earlier this month.

"I'm happy, but I'll never get back
what I lost," Cox said. "This loop
hole has been devastating."

It began in 1987 when her hus-
Cox, fell from a ladder and suffered
band, retired Army Staff Sgt. Andy

'My husband served his country for 22 years and was always promised his country would take care of him. I was going to see to it they The Coxes soon learned of a lit-kept that promise."

treatment were high but his mili-
Costs for his around-the-clock
tary-sponsored health insurance
was good-while it lasted.

tle-known provision in the 1972 law
governing the Civilian Health and
Medical Program of the Uniformed
Services, or CHAMPUS.

That loophole says that if totally
disabled patients require continuous
medical care for longer than two
years or reach 65, they are turned
over to Medicare, the government-
subsidized health care plan.

Cox, 54, who remains almost
The swap left disabled vets like
motionless in bed, with virtually no
coverage. Medicare at best has lim-
ited provisions for home care, and
termed "maintenance."
none for Cox since his case is

"You get to keep your health
insurance so long as you stay
healthy that's just not right,"
Cox said. "My husband served his
country for 22 years and was always
care of him. I was going to see to it
promised his country would take

they kept that promise."

Cox's fight took on even greater
urgency since the cost of paying for
her husband's care would eventually
lead her to personal bankruptcy.
She had to sell her home, move in
at her job as a travel agent to scrape
with her mother and work full-time
together the nearly $5,000 a month
to provide what care she could.
At first, her protests to military
officials and bureaucrats fell on deaf
ears. "I was told again and again, it's
the law. There's nothing you can do
about it."

She fired off letters to President
Bush, congressmen, senators and
military officials, asking that the law
back in CHAMPUS.
[be changed to allow her husband

Edith Smith of Springfield, Va.,
the wife of a retired Marine lieuten-
ant colonel who found himself with
out CHAMPUS coverage after a
heart ailment forced him to retire
from his civilian job, heard of Andy
the legislative campaign.
Cox's plight and agreed to support

Every week, Smith made visits to
Capitol Hill to bolster the calls and
letters with a personal voice. Con-
gressmen began to say, "If Terry
hasn't called, then Edith must be on
the way."

"I must have visited about 200
congressional offices," said Smith.
"They would always ask me, 'So
what organization are you with? I
guess they weren't used to just an
ordinary housewife dropping by."

"It was an educating process for
congressmen and senators," Cox
added. "The thing we ran into is
they didn't believe such a loophole
could exist. It couldn't happen. We
happened."
had to say it does happen-it has

More than 130 cosponsors even-
tually signed on to the House bill. In
the Senate, Hawaii Democrat Dan-
del Inouye, himself a partly disabled

"Terry Cox not only raised the
issue, but she had the persistence to
keep it on the agenda," said Gra-
ham. "I know individuals can make
things happen in government. I
know because she did it."

But Cox is still not satisfied, even
though it means her husband will
again be able to receive CHAM-
PUS-provided, 24-hour skilled nurs
ing care, physical and speech ther-
apy and prescription drugs.

Her next goal is to work for legis-
lation that would extend CHAMPUS
coverage to military retirees for
life, not just through age 65.

"I've still got my list of congress-
men to call," she said. "It's the only
way I know how to do it."