Japan's next PM Abe must deliver on economy, cope with China


TOKYO (Reuters) - Japan's hawkish ex-premier Shinzo Abe will get a second chance to run the country after his conservative Liberal Democratic Party (LDP) surged to power in Sunday's election, but must swiftly move to bolster the sagging economy while managing strained ties with China.


Abe, whose party won by a landslide just three years after a crushing defeat, was expected on Monday to meet Natsuo Yamaguchi, the leader of the small New Komeito party, to cement their alliance and confirm economic steps to boost an economy now in its fourth recession since 2000.


The victory by the LDP, which had ruled Japan for most of the past 50 years before it was ousted in 2009, will usher in a government pledged to a tough stance in a territorial row with China, a pro-nuclear energy policy despite the 2011 Fukushima disaster and a potentially risky recipe for hyper-easy monetary policy and big fiscal spending to boost growth.


Projections by TV broadcasters showed that the LDP had won at least 291 seats in the 480-member lower house, while the New Komeito party took at least 29 seats.


That gives the two parties the two-thirds majority needed to overrule parliament's upper house in most matters, where they lack a majority and which can block bills. The "super majority" could help to break a policy deadlock that has plagued the world's third biggest economy since 2007.


Markets have already pushed the yen lower and share prices higher in anticipation of an LDP victory and Abe's economic stimulus. The two-thirds "super majority" could boost share prices and weaken the yen further.


Prime Minister Yoshihiko Noda's Democratic Party of Japan (DPJ) was crushed, forecast to win just about 56 seats - less than a fifth of its showing in 2009, when it swept to power promising to pay more heed to consumers than companies and pry control of policies from bureaucrats.


But voters deemed the pledges honored mostly in the breach and the party was hit by defections before the vote due to Noda's unpopular plan to raise the sales tax to curb public debt already more than twice the size of the economy.


"This was an overwhelming rejection of the DPJ," said Gerry Curtis, a professor at New York's Columbia University.


"Abe was smart to run the campaign saying 'It's the economy, stupid. His hawkish (security) views took second place to fiscal stimulus and getting a dovish Bank of Japan governor and getting the economy going. If he keeps that focus ... he has a chance of improving his standing."


Analyst Bruce Klingner of the Heritage Foundation think tank in Washington said the return of Abe and LDP was foremost a rejection of the DPJ, but "also reflects an embrace of conservative views" after recent years of strained relations with Japan's close neighbors.


"Chinese assertiveness and North Korean provocations nudged the public from its usual post-war complacency toward a new desire to stand up for Japanese sovereignty," he said.


The Japanese favor moving toward "a more normal nation status" and are not embracing resurgent militarism, added Klingner, a former CIA analyst.


Abe, expected to be voted in by parliament on December 26, will also have to prove he has learned from the mistakes of his first administration, plagued by scandals and charges of incompetence.


Voter distaste for both major parties has spawned a clutch of new parties including the Japan Restoration Party, founded by popular Osaka Mayor Toru Hashimoto, which took at least 52 seats, according to media projections.


But media estimates showed turnout at around 59 percent, which could match the previous post-war low.


LDP leader Abe, 58, who quit as premier in 2007 citing ill health, has been talking tough in a row with China over uninhabited isles in the East China Sea, although some experts say he may temper his hard line with pragmatism once in office.


The soft-spoken grandson of a prime minister, who will become Japan's seventh premier in six years, Abe also wants to loosen the limits of a 1947 pacifist constitution on the military, so Japan can play a bigger global security role.


The LDP, which promoted atomic energy during its decades-long reign, is expected to be friendly to nuclear utilities, although deep public concerns remain over safety.


Abe has called for "unlimited" monetary easing and big spending on public works to rescue the economy. Such policies, a centerpiece of the LDP's platform for decades, have been criticized by many as wasteful pork-barrel politics.


Many economists say that prescription for "Abenomics" could create temporary growth and enable the government to go ahead with a planned initial sales tax rise in 2014 to help curb a public debt now twice the size of gross domestic product.


But it looks unlikely to cure deeper ills or bring sustainable growth to Japan's ageing society, and risks triggering a market backlash if investors decide Japan has lost control of its finances.


(Additional reporting by Paul Eckert in Washington; Editing by Tomasz Janowski and Eric Walsh)



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Football: Dortmund reclaim third, Schalke sack Stevens






BERLIN: Defending champions Borussia Dortmund moved back up to third in the Bundesliga on Sunday with a 3-1 win at strugglers Hoffenheim while neighbours Schalke 04 sacked coach Huub Stevens.

Goals by Mario Goetze, Kevin Grosskreutz and Robert Lewandowski gave Dortmund the three points, but Borussia remain 12 points behind leaders Bayern Munich, who drew 1-1 with Moenchengladbach on Friday.

Germany star Goetze, 20, opened the scoring with a superb strike from the left side of the penalty area on 26 minutes, but a defensive lapse allowed Hoffenheim to equalise when striker Sven Schipplock tapped home nine minutes later.

The champions made sure of the points when Grosskreutz tapped home on 58 minutes after some fine play from Germany's Marco Reus before Lewandowski fired home from a tight angle on 66 minutes.

"That was a spirited performance, we managed to get our heads out of the crap," said coach Jurgen Klopp.

"You could see we were lulled into a false sense of security in the first half."

This was Hoffenheim's sixth straight defeat leaving them 16th in the league, seven points from safety having sacked coach Markus Babbel on December 3.

Earlier, Schalke announced they had parted company with Dutch coach Stevens after Saturday's 3-1 home defeat to Freiburg left the Royal Blues with two points from their last six league games.

Former VfB Stuttgart coach Jens Keller will take over for the rest of the season with his side seventh in the league having been second at the end of November.

Stevens became the third Bundesliga coach sacked his season along with Felix Magath from Wolfsburg and Babbel at Hoffenheim.

Schalke, Dortmund and Bayern will all discover their Champions League opponents on Thursday when the last 16 draw is made.

On Saturday, second-placed Leverkusen beat Hamburg 3-0 to trim Bayern's lead at the top to nine points with striker Stefan Kiessling and current Germany forward Andre Schuerrle both netting.

Kiessling opened the scoring on 26 minutes when his close-range shot gave the Hamburg defence no chance and the hosts doubled their lead 10 minutes later when Schuerrle netted as the ball went in off the post.

Kiessling claimed his 12th goal in 17 games this season to make him the Bundesliga's top scorer when he latched onto a clearance from Bayer goalkeeper Bernd Leno and drilled home his second on 66 minutes.

It strengthens his case for a recall to the Germany squad in 2013 having last played in the 2010 World Cup third-place play-off win over Uruguay.

Eintracht Frankfurt are fourth, and level on 30 points with Dortmund, after their 2-0 win over 10-man Wolfsburg.

Mainz moved up to sixth after coming from behind to beat VfB Stuttgart 3-1 with midfielder Nicolai Mueller scoring their second-half goals before Colombia midfielder Elkin Soto grabbed the third in the second minute of injury time.

Duesseldorf's Denmark midfielder Ken Ilso drilled home an 83rd minute free-kick to seal Fortuna's 2-1 win over Hanover 96.

Greuther Fuerth remain rooted to the bottom of the table after they drew 1-1 at Bavarian neighbours Augsburg in a high-tension affair as both sides finished with 10 men.

- AFP/fa



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Shaheen back on Facebook, wants to ‘move around without fear’

MUMBAI: Palghar girl Shaheen Dhada has reactivated the Facebook account she disabled last month following a row over her comment on the region-wide shutdown in the wake of Bal Thackeray's death. The doughty youngster announced her return on the site with a new photo—her face no longer draped in a dupatta—and the words "I am back..!!".

Keeping the promise to restore normalcy in her life, the 21-year-old has reactivated her cellphone number and is readying her two-wheeler to travel through the lanes and bylanes of Palghar. For nearly a month, even these simple freedoms had eluded her.

Shaheen uploaded the photograph on Facebook at around 8am on Saturday. The picture was marked by the absence of the dupatta that veiled her face frequently since her arrest on November 19. "I am back and dying to roam around Palghar's streets. Now I want to move around without any fear," she told TOI.

Her return to Facebook on Saturday elicited several comments.

Within minutes, three friends welcomed her back. One friend, Ankit Upadhyaya, commented, "Back with a bang...Gr8". To this, Shaheen replied: "Yaaah." To others' greetings, Shaheen responded with thank-yous. Within hours of the account's reactivation, six people sent her friend requests. All of them she accepted.

A self-confessed Facebook addict, Shaheen expressed delight at reconnecting with the world after a month. Though she loves commenting on city news, she told TOI that she will be more careful now about what she posts on her account. On Sunday, she did not use the account.

Shaheen and her friend Rinu Srinivasan were arrested on November 19 by police on the complaint of the local Shiv Sena unit after Shaheen lamented on Facebook the region-wide shutdown on the day of Thackeray's cremation and Rinu 'liked' the comment. Police hastily applied the stringent IPC section of 295 (a) against them for hurting religious sentiments, but later changed it to IPC section 505 (2).

The nationwide outrage over the arrests forced police and the state to backtrack. Transfer orders were given to two senior policemen and a Palghar court magistrate too was moved out. Not soon after, as the Supreme Court questioned the legality of the arrests, the state director general of police and the government decided to drop the charges against Shaheen and Rinu.

The continuing support for Shaheen is evidenced by the two-dozen Facebook profiles in her name, like 'Shaheen Dhada Official' and 'Support Shaheen Dhada'. Called to share their experiences with students and faculty, Shaheen and Rinu will travel to Indian Institute of Management, Ahmedabad, on December 21-22.

But for now, Shaheen is waiting for the closure report in her case and for the police security outside her house to be lifted. "It feels like ages since I left home."

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Experts: No link between Asperger's, violence


NEW YORK (AP) — While an official has said that the 20-year-old gunman in the Connecticut school shooting had Asperger's syndrome, experts say there is no connection between the disorder and violence.


Asperger's is a mild form of autism often characterized by social awkwardness.


"There really is no clear association between Asperger's and violent behavior," said psychologist Elizabeth Laugeson, an assistant clinical professor at the University of California, Los Angeles.


Little is known about Adam Lanza, identified by police as the shooter in the Friday massacre at a Newtown, Conn., elementary school. He fatally shot his mother before going to the school and killing 20 young children, six adults and himself, authorities said.


A law enforcement official, speaking on condition of anonymity because the person was not authorized to discuss the unfolding investigation, said Lanza had been diagnosed with Asperger's.


High school classmates and others have described him as bright but painfully shy, anxious and a loner. Those kinds of symptoms are consistent with Asperger's, said psychologist Eric Butter of Nationwide Children's Hospital in Columbus, Ohio, who treats autism, including Asperger's, but has no knowledge of Lanza's case.


Research suggests people with autism do have a higher rate of aggressive behavior — outbursts, shoving or pushing or angry shouting — than the general population, he said.


"But we are not talking about the kind of planned and intentional type of violence we have seen at Newtown," he said in an email.


"These types of tragedies have occurred at the hands of individuals with many different types of personalities and psychological profiles," he added.


Autism is a developmental disorder that can range from mild to severe. Asperger's generally is thought of as a mild form. Both autism and Asperger's can be characterized by poor social skills, repetitive behavior or interests and problems communicating. Unlike classic autism, Asperger's does not typically involve delays in mental development or speech.


Experts say those with autism and related disorders are sometimes diagnosed with other mental health problems, such as depression, anxiety, bipolar disorder or obsessive-compulsive disorder.


"I think it's far more likely that what happened may have more to do with some other kind of mental health condition like depression or anxiety rather than Asperger's," Laugeson said.


She said those with Asperger's tend to focus on rules and be very law-abiding.


"There's something more to this," she said. "We just don't know what that is yet."


After much debate, the term Asperger's is being dropped from the diagnostic manual used by the nation's psychiatrists. In changes approved earlier this month, Asperger's will be incorporated under the umbrella term "autism spectrum disorder" for all the ranges of autism.


__


AP Writer Matt Apuzzo contributed to this report.


___


Online:


Asperger's information: http://1.usa.gov/3tGSp5


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Threat Forces Evacuation of Conn. Church













Members of the shattered community of Newtown, Conn., struggling to come to grips with the loss of 20 children and six adults massacred by Adam Lanza, faced a new shock today when a threat was made against a church that many of the victims and their families attend.


The St. Rose of Lima Catholic Church was evacuated during a noon service as armed police officers swarmed around the area, after a church official became aware of a credible threat and alerted parishioners mid-service to exit the building.


About 1,000 people were gathered inside the church at the time observing one of four memorial services being held there.


Witnesses said police entered the church and told parishioners that a threat had been made against the church and the surrounding area and that everyone had to leave immediately.


More than a dozen state troopers armed with assault rifles entered the church's education center next to the church, but after a short time it was determined that threat was over.


Brian Wallace, director of communications for the Diocese of Bridgeport, said that after massacre on Friday, he felt evacuation was a vital precaution to take.


"I don't think any of us could be surprised about anything after what has happened," Wallace said.


Meanwhile, police are working to understand what set Lanza off on his rampage.


ABC News has learned that investigators have seized computers belonging to the 20-year-old from the home he shared with his mother Nancy, the same place he killed her before going to the Sandy Hook Elementary School, where he slaughtered students in two first-grade classes and teachers and staff.


CLICK HERE for full coverage of the tragedy at the elementary school.


Authorities are forensically investigating those computers and are also examining devices owned by Ryan Lanza, the gunman's older brother, to see if they can learn anything more about Adam and what caused him to snap.










Connecticut Shooting: Churches Services Honor Victims Watch Video









Connecticut Shooting: Pastor Explains How Girl Played Dead to Survive Watch Video





Members of the community gathered today at churches across the small town, seeking comfort, clarity or just a cry.


With intermittent freezing rain falling, the bells tolled at St. Rose of Lima as parishioners came for the morning service.


Little more than a week before Christmas when congregants celebrate the birth of the savior, they instead were mourning the deaths of people they knew.


Many of the victims attended the church and the clergy is preparing for the funerals of eight of the children.


As parishioners arrived at the church, many stopped at a makeshift memorial with flowers, teddy bears and candles. On large white boards, people wrote notes that express condolences, hope, and even forgiveness.


One says "Rest in Peace Sweet Angels."


After a man and woman knelt down at the memorial -- the woman overcome by grief crying into her husband's arms -- two police officers opened their cars with a delivery: bouquets of flowers and teddy bears stacked in the back of their vehicles. They delicately placed each one down and then both knelt down at the vigil.


The female officer began crying and her male partner put his arm around her to comfort her. She quickly got up, walking to her car while wiping away tears, and then they pulled away.


READ: Complete List of Sandy Hook Victims


A mother and two young daughters came next. She gripped one while she also wiped away tears. A father and his young daughter also came up, the father kneeling and talking to the girl before they slowly walked into the church.


A state police trooper was also among those dropping flowers at the memorial comprised of candles, stuffed toys and a sign that says "Sleep in heavenly peace."


Police Tracing Guns Used in Shooting


Connecticut State Police Lt. Paul Vance said there are many pieces missing in the investigation and investigators continue to work inside Sandy Hook Elementary School to collect evidence.


Key to the investigation will also be the four firearms found at or near the crime scene, he said.


"We are tracing them historically, all the way back to when they were on the workbench being assembled," Vance said.


Authorities are wrapping up their processing of the exterior crime scene, which included vehicles parked in the school's lot at the time of the shooting, Vance said, and have began to release the cars back to their owners.


Vance declined to say what evidence has or has not been collected.


"We can't take segments of an investigation and discuss that publicly because something taken out of context could be misinterpreted," he said, adding that in the end, the "goal is to answer every single question.






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Egyptians vote on divisive constitution


CAIRO/ALEXANDRIA (Reuters) - Egyptians queued in long lines on Saturday to vote on a constitution promoted by its Islamist backers as the way out of a political crisis and rejected by opponents as a recipe for further divisions in the Arab world's biggest nation.


Soldiers joined police to secure the referendum after deadly protests during the buildup. Street brawls erupted again on Friday in Alexandria, Egypt's second city, but voting proceeded quietly there, with no reports of violence elsewhere.


President Mohamed Mursi provoked angry demonstrations when he issued a decree last month expanding his powers and then fast-tracked the draft constitution through an assembly dominated by his Muslim Brotherhood group and its allies. At least eight people were killed in clashes last week outside the presidential palace.


His liberal, secular and Christian opponents says the constitution is too Islamist and tramples on minority rights. Mursi's supporters say the charter is needed if progress is to be made towards democracy nearly two years after the fall of military-backed strongman Hosni Mubarak.


"The sheikhs (preachers) told us to say 'yes' and I have read the constitution and I liked it," said Adel Imam, a 53-year-old queuing to vote in a Cairo suburb. "The country will move on."


Opposition politician and Nobel Peace Prize laureate Mohamed ElBaradei wrote on Twitter: "Adoption of (a) divisive draft constitution that violates universal values and freedoms is a sure way to institutionalize instability and turmoil."


Official results will not be announced until after a second round of voting next Saturday. But partial results and unofficial tallies are likely to emerge soon after the first round, giving some idea of the outcome.


In order to pass, the constitution must be approved by more than 50 percent of voters who cast ballots. A little more than half of Egypt's electorate of 51 million are eligible to vote in the first round in Cairo and other cities.


Rights groups reported some abuses, such as polling stations opening late, officials telling people to vote "yes", bribery and intimidation.


But Gamal Eid, head of the Arab Network for Human Rights Information, which is monitoring the vote, said nothing reported so far was serious enough to invalidate the referendum.


"Until now, there is no talk of vote rigging," said Eid.


TRANSITION


Christians, making up about 10 percent of Egypt's 83 million people and who have long grumbled of discrimination, were among those waiting at a polling station in Alexandria to oppose the basic law. They fear Islamists, long repressed by Mubarak, will restrict social and other freedoms.


"I voted 'no' to the constitution out of patriotic duty," said Michael Nour, a 45-year-old Christian teacher in Alexandria. "The constitution does not represent all Egyptians."


Howaida Abdel Azeem, a post office employee, said: "I said 'yes' because I want the destruction the country is living through to be over and the crisis to pass, and then we can fix things later."


Islamists are counting on their disciplined ranks of supporters and the many Egyptians who may fall into line in the hope of ending turmoil that has hammered the economy and sent Egypt's pound to eight-year lows against the dollar.


Mursi was among the early voters after polls opened at 8 a.m. (1:00 a.m. Eastern Time). He was shown on television casting his ballot shielded by a screen and then dipping his finger in ink - a measure to prevent people voting twice.


Turnout was high enough for voting on Saturday to be extended by four hours to 11 p.m. (4 p.m. Eastern Time). One senior official on the committee overseeing the referendum said Saturday's vote could continue on Sunday if crowds were too heavy to allow everyone to cast ballots in one day. Voting for Egyptians abroad that began on Wednesday has been extended to Monday, the state news agency reported.


After weeks of turbulence, there has been limited public campaigning. Opposition politicians and parties, beaten in two elections since Mubarak's overthrow, only announced on Wednesday that they backed a "no" vote instead of a boycott.


TWO DAYS


The second round will be held in other regions on December 22 because there are not enough judges willing to monitor all polling stations after some said they would boycott the vote.


Egyptians are being asked to accept or reject a constitution that must be in place before a parliamentary election can be held next year to replace an Islamist-led parliament dissolved in June. Many hope this will lead Egypt towards stability.


If the constitution is voted down, a new assembly will have to be formed to draft a revised version, a process that could take up to nine months.


The army has deployed about 120,000 troops and 6,000 tanks and armored vehicles to protect polling stations and other government buildings. While the military backed Mubarak and his predecessors, it has not intervened in the present crisis.


(Writing by Edmund Blair and Giles Elgood; Editing by Tom Pfeiffer)



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Swimming: Chinese star Ye wins 200m medley gold






ISTANBUL: Chinese teenager Ye Shiwen added the world shortcourse 200m individual medley title to her two Olympic golds on Saturday when she clinched victory in 2 minutes 4.64 seconds.

Ye, 16, who took Olympic gold in the 200m and 400m medleys in London, finished ahead of Hungary's Katinka Hosszu and Hannah Miley of Great Britain.

"I'm so happy I came in first today. It feels so good," said Ye, after setting a new championship record.

"I competed against Hosszu many times in many events. This time she was stronger than ever. But I thought 'for sure I won't give up'. I had a chance to come back because in the breaststroke she is not so strong."

- AFP/de



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Jundal is an Indian operative: Rehman Malik

NEW DELHI: A day after he offended his hosts by seeking to draw a comparison between Babri demolition and Mumbai terror attack, Rehman Malik was at it again on Saturday. The visiting interior minister festered India's 26/11 wound by saying that Abu Jundal, who had coordinated the terror strikes of Ajmal Kasab and nine other Laskhar terrorists from the Karachi control room, worked for an Indian intelligence agency.

"Abu Jundal is an Indian. We are also curious as to how he and others landed in Pakistan. He was a known criminal. He worked as a source of an Indian intelligence agency. I am not saying this. He himself has said so. I have seen records," Malik said in an exclusive conversation with the TOI.

The remark may outrage the Indian government, considering Pakistan went to great lengths to block Jundal's deportation from Saudi Arabia. Pakistan's diplomats had even told Saudi authorities that Jundal was a Pakistani, citing the passport and the national identity number issued to him.

In fact, while talking to TOI, Malik also underlined the involvement of two other Indians, including Ansari (Fahimuddin?) in the 26/11 attack, who had been to Pakistan. "We have to figure out all these...whether non-state actors from the two sides are acting at the instance of a third power. You are aware that things had taken an alarming turn, with both countries massing their troops on the border. Things would have been worse if the leadership on both sides had not shown maturity," said Malik, who is on a three-day official visit to India.

Denying the charge that Pakistan was reluctant to get to the bottom of the conspiracy behind 26/11 specifically when all evidence are there on Pakistani soil, Malik said that the trial would have been completed by now if a Judicial Commission from Pakistan had been allowed to cross-examine the four crucial Indian witnesses in the Mumbai attack case when it had visited India (in March, 2012). He also said that with the Indian government agreeing to let in the judicial commission visit Mumbai and cross-examine the witnesses "very soon", the trial in Pakistan (of Lashkar commander Zaki-ur-Rahman Lakhvi and six other accused) in the 26/11 case would be concluded swiftly.

Responding to a question, Malik repeated his insistence that the two countries should let bygones and be bygones in order to have better ties: a pitch which is seen by here as code for saying that India should drop its insistence for punishment to 26/11 perpetrators as the pre-condition for discussing Jammu & Kashmir and other contentious issues.

However, he avoided a specific answer when asked the same "let's-move-on by forgetting the past" should require Pakistan to withdraw its claims over J&K. "We have to forget that India and Pakistan are enemies... We are converging on Kashmir issue. It is part of composite dialogue... we are not forgetting 26/11... I am not saying forget the incident. I am only saying that forget the feeling of animosity. Let us create an era of brightness".

Malik, who met PM Manmohan Singh on Saturday, sought to douse the controversy he triggered by drawing a parallel between the Babri demolition and the terror attack on Mumbai. "There is no comparison whatsoever between Babri Masjid demolition and the 26/11 attacks. Babri mosque (demolition) was actually an ethnic issue... It was actually a sectarian strife... My remarks should not be taken in a negative way. I have no intention to interfere with inter-faith matters," said the visiting minister, adding that Pakistan itself is a victim of sectarian strife among the Shias and the Sunnis.

The former police officer, who is known for his loyalty to the Bhutto clan, had on Friday hushed his host Indian home minister Sushilkumar Shinde by seeking to draw a parity between the 1992 demolition of Ayodhya mosque and the lethal assault on Mumbai in November, 2008.

Malik clarified that his intention was not to cause controversy or hurt anyone, claiming that he was merely trying to alert both countries to the consequences of sectarian violence. "Extremism is on the rise on both sides, and steps should be taken to check it," he said.

The Pakistani interior minister said he during his meetings with both the PM and national security advisor Shivshankar Menon pitched that Indian agencies should share the details of their investigations into 26/11 with Islamabad.

He claimed that the frostiness in ties post-26/11 has already thawed. "I have found great hope between people of the two countries... incidents are happening because we were not every close ... after Bombay (Mumbai) blats, how many things have happened?... Whenever India has said we suspect some area we have searched and even shared info... Intelligence to intelligence, government to government and ministry to ministry... everybody is interacting. With interaction comes friendship. All incidents happening can be averted with friendship... you are spending millions we are spending million (security)... we have to fight poverty and extremism. At government level, we have done many things...now people-to-people contact will clear the misunderstanding. We have created a situation for this now".

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Fewer health care options for illegal immigrants


ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.


The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.


To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.


But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.


When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.


And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.


In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."


The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.


Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.


Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.


A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.


California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.


The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.


And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.


If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.


Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.


The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.


"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."


Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.


There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.


Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.


For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.


"They always attended to me," she said, "even though it's slow."


___


Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .


Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .


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'Good Evidence' on Massacre Motive













Police are investigating reports that Connecticut gunman Adam Lanza had an altercation at the Sandy Hook Elementary School in the days before he carried out a massacre the school's students and staff, sources told ABC News.


Authorities indicated today that they have "some very good evidence" about the motive behind Lanza's shooting spree at the school in Newtown, Conn., and said that the sole person to survive being shot by Lanza will be "instrumental" in the probe.


The grim task of identifying all of Lanza's 27 victims, which included 20 children, was completed today. Families, who already feared the worst, were informed that their loved ones were dead early today.


All of the bodies have now been removed from the school and medical examiners are expected to provide a full list of victims later today.


With the tally of Lanza's carnage complete, authorities and the grieving people of Newtown, Conn., are left to wonder why he turned the elementary school in this quaint New England town into a slaughter house.


CLICK HERE for full coverage of the tragedy at the elementary school.






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Connecticut State Police Lt. Paul Vance, who had compared the investigation to "peeling back the layers of an onion," said the investigation "did produce some very good evidence" about motive, but he would not go into further detail.


He indicated the evidence came from the shooting scene at the school as well as at the home where Lanza's mother, Nancy, was slain.


Also key will be the lone person shot by Lanza who wasn't killed. The female teacher has not been publicly identified.


"She is doing fine," Vance said at a news conference today. "She has been treated and she'll be instrumental in this investigation."


In addition, sources told ABC News authorities are investigating reports that Lanza had an altercation at the school just days before the attack.


Vance said that Lanza forced his way into the school, but did not say how.


Evidence emerged today that Lanza's rampage began in the office of school principal Dawn Hochsprung while the school intercom was on. It's not clear whether it was turned on to alert the school or whether it was on for morning announcements, but the principal's screams and the cries of children heard throughout the school gave teachers time to take precautions to protect their children.


Hochsprung was among those killed in the Friday morning killing spree.


READ: Connecticut Shooter Adam Lanza: 'Obviously Not Well'


Authorities have fanned out to New Jersey, Connecticut and Massachusetts to interview Lanza's relatives, ABC News has learned.


According to sources, Lanza shot his mother in the face, then left his house armed with at least two semi-automatic handguns, a Glock and a Sig Sauer, and a semi-automatic rifle. He was also wearing a bulletproof vest.






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