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.

President Barack Obama congratulated Abe and underlined U.S. interest in working with the longstanding American ally.

"The U.S-Japan Alliance serves as the cornerstone of peace and prosperity in the Asia-Pacific and I look forward to working closely with the next government and the people of Japan on a range of important bilateral, regional and global issues," he said in a statement.

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)

Read More..

Fewer students choosing to retake PSLE

SINGAPORE: Amid the national debate on the Primary School Leaving Examination (PSLE) - including whether it has become a be-all and end-all for 12- year-olds - less pupils are choosing to retake the PSLE compared to previous years, as other education paths become available and awareness of such options grows.

Since 2007, NorthLight School and Assumption Pathway School - which opened their doors in 2007 and 2009 respectively - have been set up to provide vocational programmes for students who fail their PSLE and teach subjects such as Mathematics through more hands-on and practical methods.

In the five years before 2007, an average of two to three per cent of the cohort - or between 1,028 and 1,542 students - retook the PSLE each year. After 2007, this proportion fell to an average of one to two per cent of the cohort, or between 477 and 954 students each year.

Responding to media queries, the Ministry of Education (MOE) attributed this trend to the availability of new progression paths and learning support programmes in schools to help weaker students.

Changes in the education system such as subject-based banding have also contributed to fewer students retaking their PSLE, said the MOE.

This allows students to take subjects at either Foundation or Standard level, depending on what best suits their abilities, before they sit for the PSLE.

Together, NorthLight and Assumption Pathway take in about 350 pupils each year. Assumption Pathway Principal Wee Tat Chuen observed that the number of students coming to the school after their second or third try at the PSLE has fallen over the years.

Currently, most of its intake consists of students who failed the PSLE for the first time.

"I am starting to see more openness where parents are opting for a learning experience that best suits the child," said Mr Wee, adding that the public is also starting to see that vocational skills can be useful and progression is still possible even if a student does not perform well at the PSLE.

Former NorthLight student Thang Yuan Ting, 19, believes that not everything hinges on the PSLE. A graduate of the Institute of Technical Education, she is now happily employed in the retail sector.

Entering NorthLight after two unsuccessful attempts at the PSLE, Ms Thang said that she retook the PSLE to give herself another shot at Mathematics - her weakest subject.

But at NorthLight, she found herself enjoying learning more as teachers used kinesthetic methods and she could also try her hand at activities like drawing.

"I do not think that the PSLE is the end … there are still many options available and we can choose what we like," she said.

- TODAY

Read More..

Even ATMs freeze in Himachal cold

MANALI/SHIMLA/DHARAMSHALA: It's snowed in Himachal and there's already a cold wave in Delhi. Soon, tourists from all over the country will flock to the hill station to experience the chill, sometimes even eating the snow.

But life for those living in the higher reaches can get very tough — from lighting a fire under the fuel tank of your vehicle in the morning to melt the frozen diesel just to start it, or pouring buckets of boiling water to free frozen pipes for the liquid to pour out of taps. Often when there's disturbance on their TV sets, people scramble onto the roof to clear thick layers of frost on the DTH dish, opening up the transmission. And it's not unusual to see a queue outside an ATM counter, waiting till noon for the machine to be eased up by the rays of an unsure sun.

In Spiti, even tears turn into crystals

In fact, if you are in Lahaul Spiti, you can't even cry too much as the tears turn into small drops of crystals that stick to your face, making you look somewhat silly.

There will be tourists flocking to the hill stations and towns of Himachal, some of the most beautiful in the country, to celebrate Christmas and New Year, but away from the fun and frolic, life is something else altogether. It's a battle just to stay afloat.

Unbelievable as it may seem, the first thing Sher Singh Bodh, a resident of Keylong town in Lahaul-Spiti district, does after he wakes up is boil a bucket of water to pour over frozen taps. Then he lights a fire under the fuel tank of his jeep. But he's used to it by now - in Lahaul valley, the cold desert of Himachal Pradesh, even wall clocks freeze up. So do wrist watches and cellular phones.

As the entire district is cut off from the rest of the world for the next five months, tribals stock up everything in advance - from food to funeral paraphernalia. And, this is just the beginning. In the initial phase of winter, mercury dips only up to -8 degree Celsius in Keylong; it is below -12 degree Celsius at Khoksar. Later, in January, the minimum temperature dips to -20 degree Celsius in Keylong. In Lahaul, at about 11,000 feet, it plunges to below -30 degree Celsius.

The chill froze the only ATM machine of Lahaul last fortnight and bank officials have been heating it up every day to make it work. Fearing electronic voting machines (EVMs), too, would meet the same fate, the Election Commission had them shifted from Lahaul to Kullu soon after assembly elections on November 4.

River Chenab, which originates in Lahaul-Spiti and feeds the fields of Pakistan, has already frozen partially. With the closure of the Manali-Leh road due to heavy snowfall at the 13,050-feet Rohtang Pass, people in Lahaul-Spiti are now locked inside the valley, with the only mode of transport for them being state-run choppers. For tourists then, it's best to limit the travel to Kufri and thereabouts, where you can ride yaks and eat some snow.

Read More..

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

Read More..

Conn. Community Mourns Victims of Massacre

President Obama will visit Newtown, Conn. today to meet with the grieving families and thank the first responders from Friday's school shooting, as the community begins the long process of healing.

The pictures of the young victims killed at Sandy Hook Elementary School emerged Saturday, along with a remarkable story of survival.

Twenty children and six adults were killed at the school when shooter Adam Lanza went on a shooting rampage.

Later this evening, the community will gather for an interfaith vigil, where the president is scheduled to address mourners, some from out of state who came to offer help and others, who knew the young victims or their families.

Addressing the nation on Friday, Obama mourned the children who "had their entire lives ahead of them -- birthdays, graduations, weddings, kids of their own."

Story of Survival

READ: Complete List of Sandy Hook Victims

The lone survivor of her class tricked the gunman by playing dead, the girl's pastor told ABC News, before running out of the school covered in the blood of her classmates.

"She ran out of the school building covered from head to toe with blood and the first thing she said to her mom was, 'Mommy, I'm OK but all my friends are dead,'" said Pastor Jim Solomon. "Somehow in that moment, by God's grace, [she] was able to act as she was already deceased."

Five first graders in another class were also killed, along with six staff members.

Connecticut Shooting: Churches Services Honor Victims Watch Video

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

"The mom told me, and I thought this was very insightful, that she was suffering from what she felt was survivor's guilt because so many of her friends no longer have their children but she has hers," the pastor said.

Click Here for full coverage of the tragedy at the elementary school.

Remembering the Victims of the Sandy Hook Shooting

There was Emilie Parker, the little girl with the blond hair and bright blue eyes, who would have been one of the first to comfort her classmates at Sandy Hook Elementary School, had a gunman's bullets not claimed her life, her father said.

Noah Pozner and his twin sister had just celebrated their sixth birthdays. His twin sister survived the shooting, but Noah did not.

Six-year-old Jesse Lewis went to school on Friday, excited to make gingerbread houses. He died, along with his teacher, Victoria Soto, 27, whose family said was shielding some of her first graders when she was hit by bullets.

As the community mourns and families bear the pain of planning 26 funerals before Christmas, school board members hope to get students back to a familiar routine.

"Well, all the mental health experts we've talked to...tell us that the best thing we can do is to get back to normal operations as soon as possible," said Bill Hart, a member of the Newtown Board of Education.

"We know some teachers won't be prepared to come back, he said. "We are going to be prepared with substitutes. We've got counseling for all. We're prepared to do whatever we have to do to help all of our community."

READ: Police Seek Motive in Shooting

Students who attend Sandy Hook Elementary School will be moved to another location that has yet to be announced, Hart said. He said officials did not yet know what would become of the building that was turned into a slaughterhouse on Friday.

"I think trying to understand what we are going to do with that is a long process and we're not in any way prepared to make those decisions now," he said.

ABC News' Lara Spencer and Dan Harris contributed reporting.

Read More..

Violence flares in Cairo as Egyptians vote

CAIRO (Reuters) - Islamists attacked the offices of an Egyptian opposition party newspaper on Saturday, security sources said, as people voted on a new constitution intended to pull the country out of a growing political crisis.

The newspaper of the Wafd party in Cairo was targeted with petrol bombs and birdshot, the sources said, in the latest of a series of violent incidents surrounding a divisive referendum designed to pave the way to national elections next year.

The attack came as officials began counting votes after polling stations closed at 11 p.m. (1600 ET).

Official results will not come until after a second round of voting in remaining areas of the country next Saturday, but conflicting claims were already emerging from the rival camps.

A spokesman for the opposition National Salvation Front said it had indications that 60-65 percent of voters in Cairo and other cities had rejected the new constitution, while President Mohamed Mursi's Muslim Brotherhood allies said that after 1 million votes had been counted, 72.5 percent were in favor.

Mostafa Shafik, managing editor at Wafd's newspaper, which is located next to the party headquarters, said his offices had been damaged.

"The attackers used Molotov cocktails to enter, which left minor areas burned," he said.

A Reuters photographer saw a dozen or so cars damaged inside the Wafd headquarters' grounds, their windows broken. Glass was also broken in the headquarters, but he saw no immediate signs of fire damage. Two people appeared to have been injured.

Wafd blamed followers of Hazem Abu Ismail, a Salafist preacher, for the attack, but he used his Facebook page to deny involvement.

Violence in Cairo and other cities has marred the run-up to the referendum. Several party buildings belonging to the Muslim Brotherhood's Freedom and Justice party have been burned in protests.

Rival factions armed with clubs, knives and swords fought in the streets of Alexandria on Friday. Opposition supporters trapped a Muslim preacher inside his mosque after he backed a "yes" vote in favor of the constitution.

ANGRY DEMONSTRATIONS

President 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 say 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 53-year-old Adel Imam as he queued to vote in Cairo on Saturday. "The country will move on."

Turnout was high enough for voting to be extended by four hours in Cairo and some other cities.

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.

TRANSITION

Christians, making up about 10 percent of Egypt's 83 million people and who have long complained 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."

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. (0600 GMT). 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.

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 armoured 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)

Read More..

Russia arrests opposition leaders at banned rally

MOSCOW: Russian police on Saturday arrested several opposition leaders, including well-known blogger Alexei Navalny, as hundreds of people packed a central Moscow square in defiance of an official ban to protest Vladimir Putin's rule.

Scores of Muscovites, many holding white roses, defied the authorities by turning up at Lubyanka Square, the seat of the FSB security services, despite temperatures of minus 14 degrees C (seven degrees F) and warnings that the unsanctioned rally would be broken up.

Navalny, possibly the most charismatic figure in the protest movement against the Russian president, was detained a day after investigators launched a new criminal probe against him for suspected fraud. patisserie

"It's raving mad. (They) simply snatched me from the crowd," Navalny tweeted from inside a police van.

Besides Navalny, police also arrested Sergei Udaltsov, the leader of leftist group the Left Front, and activists Ilya Yashin and Ksenia Sobchak, the daughter of Putin's late mentor Anatoly Sobchak.

"Looks like I am a very dangerous criminal," Sobchak quipped on Twitter.

The prominent figures arrested all noted on Twitter that the police vans holding them had been equipped with webcams to keep close watch on their behaviour.

Police put the turnout at around 500 people, half of them journalists and bloggers, but an AFP correspondent said the real number of the protesters appeared to be significantly higher.

People laid white lilies, carnations and chrysanthemums at the Solovetsky Stone, a monument to victims of Stalin-era purges adorning the square, as a helicopter hovered overhead.

One hour into the rally, the monument was blanketed by piles of flowers.

"Our authorities are repressive," one protester, 48-year-old businessman Andrei Genin, told AFP, sporting a white ribbon, the symbol of the opposition movement against Putin.

City authorities had earlier banned an opposition march through the city, and the opposition Coordination Council had urged Russians to simply turn up at Lubyanka Square.

On the eve of the protest, Russian authorities launched a second major investigation against Navalny, accusing the protest leader and his brother Oleg of embezzling 55 million rubles ($1.8 million, 1.4 million euros) from a trading company.

Navalny, who has already been charged with embezzlement in an earlier case in which he faces up to 10 years in prison, vowed to press ahead with his political activism.

In a separate event, his supporters convened in the Russian capital to establish a new political party that would represent the interests of middle-class urbanities, the backbone of the anti-Putin protests.

Dubbed "The Popular Alliance", the party will promote the "middle class and the European choice", activist Leonid Volkov told Echo of Moscow radio, noting that Navalny himself would not be an official member.

The opposition movement is hoping to maintain momentum despite internal divisions between liberals, leftists and nationalists and the authorities' tough crackdown on dissenters since Putin's return to the Kremlin in May.

Even supporters admit that the euphoria that marked the first opposition protests that erupted after fraud-tainted parliamentary polls last December has largely died down.

Up to 120,000 people gathered near the Kremlin walls at the peak of the protests last winter, a huge number for a country that lost its taste for street politics after the turbulent 1990s.

The last major rally, in September, drew around 14,000 people, according to police, though the opposition argued many more had shown up.

Weeks after his inauguration, Putin signed off on a raft of laws that critics have attacked as a bid to quash dissent.

Scores of activists now face jail time for taking part in a May 6 protest on the eve of Putin's inauguration and for alleged plans to overthrow the Russian strongman with the help of foreign sponsors.

Ahead of Saturday's rally, Moscow prosecutors delivered a warning to leading activists, while police urged Russians to refrain from "provocations".

Smaller rallies were held in several cities across Russia.

Sixty people held a 40-minute march in Tomsk in western Siberia despite temperatures of minus 35 degrees C, a representative of the Solidarnost (Solidarity) movement, Ksenia Fadeyeva, told AFP.

Fourteen people marched in the city of Krasnoyarsk in eastern Siberia, police said.

- AFP/de

Read More..

Interaction key to end Kudankulam-like stir: IAEA chief

KORIYAMA (FUKUSHIMA): UN nuclear watchdog IAEA chief Yukiya Amano on Saturday called for 'better communication and higher transparency' in dealing with Kudankulam-like protests. Even as he sought to distance himself from both sides — protesters as well as votaries of nuclear power —the director-general said that the issue of spent N-fuel, which is at the core of protests in India, was one of the lessons the world learnt from the accident at Fukushima Daiichi N-plant in Japan last year.

Amano was talking exclusively to TOI here on the sidelines of the Fukushima ministerial conference that saw many smaller countries pleading for nuclear power generation to deal with rising fossil fuel prices and climate change issues. The conference, which was presided over by Japanese foreign minister Koichiro Gemba, was held to strengthen N- safety worldwide.

"I don't have any particular comment on opposition to nuclear power anywhere, or those who support it, but if I can give a recommendation, we need to share both good news and bad news to be able to get a better understanding of the problem," he told TOI, replying to a query about protests in India that have delayed the commissioning of the first unit at Kudankulam.

"Communication is one of the areas where we need to improve and IAEA has been organizing meetings of global experts to look into this. We have to explain complicated things in a simple manner and it is only through better communication and higher transparency that we can achieve this," he added.

Amano admitted that the safety aspect of the spent N-fuel was a very important issue. The government's 'success' in acquiring reprocessing rights from Russia has become a millstone around its neck as this prevents it from sending the spent or used fuel back to Russia. The government painstakingly maintains that it considers spent fuel an asset that is used to produce electricity.

Read More..

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 .

Read More..

Conn. Shooter Adam Lanza: Quiet, Bright, Troubled

Adam Lanza, the 20-year-old who killed 20 kids and six adults at a Connecticut elementary school Friday, was very bright, say neighbors and former classmates, but he was also socially awkward and deeply troubled.

"[Adam] was not connected with the other kids," said family friend Barbara Frey. A relative told ABC News that Adam was "obviously not well."

READ full ABC News coverage of the Connecticut shootings.

On Friday morning, Lanza shot his mother Nancy in the face at the home they shared in Newtown, and then drove her car to Sandy Hook Elementary School. Dressed in black combat gear, he broke a window at the school, which had recently had a new security system installed, and within minutes had shot and killed six adults and 20 schoolchildren between the ages of five and 10.

The shooting stopped when Lanza put a bullet in his own head. Multiple weapons were found at the scene, including two semiautomatic handguns registered to his mother. A Bushmaster rifle registered to Nancy was discovered outside in the car.

Long before Lanza's spree, however, residents of Newtown had noticed that tall, pale boy was different, and believed he had some kind of unspecified personality disorder.

"Adam Lanza has been a weird kid since we were five years old," wrote aneighbor and former classmate Timothy Dalton on Twitter. "As horrible as this was, I can't say I am surprised."

In school, Lanza carried a black briefcase and spoke little. Every day, he wore a sort of uniform: khakis and a shirt buttoned up to the neck, with pens lined up in his shirt pocket.

Newtown School Massacre: 20 Children, 7 Adults Dead Watch Video

Newtown Teacher Kept 1st Graders Calm During Massacre Watch Video

A former classmate in his 10th grade honors English class, Olivia DeVivo, says he "was always very nervous and socially awkward."

She told ABC News that "he didn't really want to be spoken to" and that when teachers would call on him "it appeared physically difficult for him to speak."

Lanza avoided public attention and had few, if any, friends. He liked to sit near the door of the classroom to make a quick exit.

He even managed to avoid having his picture in his high school yearbook. Instead of his portrait, the space reserved for Adam Lanza says "Camera Shy." And unlike most in his age group, he seems to have left little imprint on the internet – no Facebook page, no Twitter account.

Lanza's parents Peter and Nancy Lanza married in New Hampshire in 1981, and had two sons, Adam and his older brother Ryan, who is now 24 and lives in New Jersey.

The Lanzas divorced in 2009 after 28 years of marriage due to "irreconcilable differences." When they first filed for divorce in 2008, a judge ordered that they participate in a "parenting education program."

Adam was 17 at the time of the divorce. He continued to live in Newtown with his mother. His father now lives in his Stamford, Connecticut with his second wife.

Peter Lanza, who drove to northern New Jersey to talk to police and the FBI, is a vice president at GE Capital and had been a partner at global accounting giant Ernst & Young.

Adam's older brother Ryan Lanza, 24, has worked at Ernst & Young for four years, apparently following in his father's footsteps and carving out a solid niche in the tax practice. He too was interviewed by the FBI. Neither he nor his father is under any suspicion.

"[Ryan] is a tax guy and he is clean as a whistle," a source familiar with his work said.

Police had initially identified Ryan as the killer. Ryan sent out a series of Facebook posts saying it wasn't him and that he was at work all day. Video records as well as card swipes at Ernst & Young verified his statement that he had been at the office.

Two federal sources told ABC News that identification belonging to Ryan Lanza was found at the scene of the mass shooting. They say that identification may have led to the confusion by authorities during the first hours after the shooting.

Click Here for the Blotter Homepage.

Read More..