Newtown Boy Remembered as 'Old Soul'

Dec 17, 2012 6:02pm

Family of Daniel Barden, who died in the Connecticut school shootings. From left, his brother James, 12, and his parents, Mark and Jackie. (Image Credit: ABC)

Though he was only in first grade, Daniel Barden was very much an “old soul,” his family said today.  He was one of the 20 children who died Friday at Sandy Hook Elementary School in Newtown, Conn.

At the age of 4, he displayed an empathy for others remarkable for a child so young.  It didn’t go unnoticed — teachers chose Daniel to be paired with a special education student at his school.

PHOTOS: Connecticut Shooting Victims

His mother, Jackie Barden, said she was always struck by “how unusual he was.”

“Our neighbors always said, ‘He’s like an old soul,’” Barden said during an interview on “Katie.”

He carried that kindness with him as he got older.

“He would hold doors open for adults all the time,” said his father, Mark Barden.

He laughed, remembering the times he’d be “halfway” across a parking lot and see his son still holding a door for strangers.

“Our son had so much love to give to this world,” Barden said. “He was supposed to have a whole lifetime of bringing that light to the world.”

Complete Coverage: Sandy Hook Elementary School Shooting

Daniel had two older siblings, James, age 12, and Natalie, age 10, who doted on their little brother.

“He was just so sweet and kind and thoughtful,” James said.

On Friday, 7-year-old Daniel, who was one of the 20 young victims at Sandy Hook Elementary School, woke up early.  He played foosball with his mother.

As usual, Daniel won, she said. The score was 10 to 8.

His father also taught him how to play “Jingle Bells” on the piano that morning.

“We did a lot in that half hour,” he said.

A celebration of Daniel’s life will be held Tuesday at St. Rose of Lima Catholic Church. A funeral is scheduled for Wednesday.

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

TOKYO (Reuters) - Conservative ex-premier Shinzo Abe will get a second chance to lead Japan after his Liberal Democratic Party surged back to power in Sunday's election, but he must move swiftly to bolster a sagging economy and manage strained ties with China to avoid the fate of his short-lived predecessors.

Abe, whose party won by a landslide just three years after a crushing defeat, is due to meet the leader of its small ally on Monday 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 294 seats in the 480-member lower house, while its ally the New Komeito party took 31 seats.

That gives them a two-thirds majority needed to overrule parliament's upper house in most matters. Since 2007, successive governments have been hamstrung by a "twisted parliament" where ruling coalitions lacked control over the upper house, which could block most legislation.

While investors have already pushed the yen lower and share prices higher in anticipation of an LDP victory and Abe's economic stimulus, the "super majority" drove the yen to a 20-month low against the U.S. dollar as far as 84.48.

Japan's benchmark Nikkei opened up 1.6 pct on Monday, hitting a high of more than eight months.

Prime Minister Yoshihiko Noda's Democratic Party of Japan (DPJ) was crushed. It was forecast to win 57 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 felt the DPJ failed to live up to those pledges 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, which is 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. That sentiment was echoed in Japanese media.

"In a word, rather than a huge victory for the LDP, this election was a massive defeat for the Democrats," the Nikkei business daily said in an editorial.

Analyst Bruce Klingner of the Heritage Foundation think tank in Washington agreed, but said it "also reflects an embrace of conservative views" after strained relations with Japan's neighbors in recent years.

"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.

However, that did not mean the Japanese were embracing a return to militarism, added Klingner, a former CIA analyst.

LOW TURNOUT

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 54 seats according to media projections.

Media estimates also 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," he said in a statement.

Abe, who visited China first during his first term, said he would start off this time by going to Washington.

The LDP, which promoted nuclear energy during its decades-long reign, is expected to be friendly to power 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.

Jiji news agency said previous LDP Prime Minister Taro Aso, 72, could be tapped as finance minister and deputy premier. He launched massive economic stimulus packages to fight the impact of the 2008-2009 global financial crisis but was dogged by policy flipflops and gaffes.

Many economists say that prescription for "Abenomics" could create temporary growth that would allow the government to proceed with a planned initial sales tax rise in 2014 to help curb public debt.

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.

(Editing by Tomasz Janowski and Paul Tait)

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Actor Depardieu 'giving up French passport' in tax row

PARIS: France's leading actor Gerard Depardieu said Sunday he is giving up his French passport after the prime minister called him "pathetic" for seeking to avoid taxes by moving to Belgium.

In an open letter to Prime Minister Jean-Marc Ayrault, the 63-year-old "Cyrano de Bergerac" and "Jean de Florette" film star said he had been treated unfairly after years of supporting France, and paying millions of euros in taxes.

"I am not asking to be approved of, but I could at least be respected.

"All of those who have left France have not been insulted as I have been," he said in the letter published in the weekly newspaper "Le Journal du Dimanche".

Depardieu has joined some of France's wealthiest business figures in Belgium following moves by President Francois Hollande's Socialist government to tax annual incomes above one million euros ($1.3 million) at 75 percent.

In the letter, Depardieu, who has extensive business interests including wine estates and three Paris restaurants, accused the Socialists of driving France's most talented figures out of the country.

"I am leaving because you consider that success, creation, talent, anything different, must be punished," he said.

Depardieu said that over 45 years of working and running businesses in France he had paid 145 million euros to state coffers.

"At no time have I failed in my duties. The historic films in which I took part bear witness to my love of France and its history," Depardieu said.

He started working at the age of 14 and never claimed social security, the star added.

"Who are you to judge me in this way?" he asked Ayrault.

Ayrault's comments came after it emerged that Depardieu had taken up residence in Nechin, a tiny village just over the border in Belgium, which is a favoured spot for wealthy French nationals avoiding tax.

"I find it quite pathetic," Ayrault had said. "Everyone loves him as an artist, but paying your taxes is an act of solidarity and patriotism."

Hailed as one of the greatest actors of his generation, Depardieu has in recent years become as famed for his erratic behaviour as for his acting talents.

He had been due to appear in court on Thursday on charges of driving his scooter drunk through Paris, but the hearing was postponed.

In August he was cautioned after punching a car driver who had forced him to swerve on his scooter, and last year he generated global headlines when he urinated in a bottle aboard a plane as it prepared to take off from Paris for Dublin.

- AFP/ha

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Railways to adopt PPP mode for modernization: Bansal

SANGRUR: Union railway minister Pawan Bansal said on Sunday that public private partnership (PPP) mode would be adopted for modernizing and upgrading the railway infrastructure.

The minister, who was in Sangrur and Barnala districts of Punjab to lay the foundation stones for new railway projects, said that Rs 1.10 lakh crore would be generated through PPP mode for implementing the revamping plan.

"Railways is failing in mobilizing the required funds through internal sources. The annual plan for the ongoing fiscal has been cut short by over Rs 4,000 crore and the plan outlay has been reduced from earlier Rs 60,100 crore to Rs 55,900 crore," he said.

Bansal, who belongs to Tapa town of Barnala district, said, "The railways has chalked out ambitious plans for doubling the tracks, electrification, laying of new railway lines and manufacture of coaches in the next five years. All this will be done on PPP mode."

Bansal said that railways will need about 30,000 more coaches in the coming years and for this, all the states have been asked to provide land on which railways will set up coach factories.

"Both Punjab and Haryana have already shown keen interest in the plan," said Bansal.

He said that presently, there are 14,000 unmanned railway crossings in India and the railways is inching towards making these manned in a phased manner.

Bansal said that the Kolkata-Ludhiana and Delhi-Mumbai freight corridors will be completed during the next five years.

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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.

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AP Writer Matt Apuzzo contributed to this report.

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Online:

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

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Obama Offers Newtown 'Love and Prayers of a Nation'

President Obama told the grieving community of Newtown, Conn., that the nation has wept with them for the loss of 20 children and six teachers and school staff members killed in a senseless massacre.

Grim-faced, Obama took the stage at Newtown High School auditorium to speak at a memorial service for the first graders, teachers, principal and other school staff members killed Friday by 20-year-old Adam Lanza at the Sandy Hook Elementary School.

"I come to offer the love and prayers of a nation," the president said. "I am very mindful that mere words cannot match the depths of your sorrow nor can they heal your wounded hearts. I can only hope it helps to know you are not alone ... and that all across this land we have wept with you."

The memorial service had been delayed nearly an hour as Obama met with families of the victims -- 20 first graders and six adults -- in classrooms of the high school, but the audience sat patiently awaiting the service.

The president walked in shortly before 8 p.m., gave a brief wave to the room full of parents, friends and neighbors, before taking a seat in the first row.

He was greeted with a standing ovation as he the auditorium, and quickly took his seat in the first row to await his turn to speak in the interfaith memorial service.

Mandel Ngan/AFP/Getty Images

President Obama: 'Newtown You Are Not Alone' Watch Video

Sandy Hook Elementary Shooting: Remembering the Victims Watch Video

"We needed this. We needed to be together, here in this room, in the gymnasium, outside the doors of this school, in living rooms around the world, we needed to be together to show that we are together and united," said Rev. Matt Crebbin, senior minister of the Newtown Congregational Church, who opened the ceremony.

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

"We gather in such a moment of heartbreak for all of us in Newtown," he said. "We gather esp mindful of family and friends and neighbors among us who have lost loved ones by an act of unfathomable violence and destruction.

"These darkest days of our community shall not be the final word heard from us," he said

Tragedy struck the small town Friday when Adam Lanza broke into the elementary school with a semiautomatic rifle and two handguns, and then killed 20 first graders and six school staff members before committing suicide as police arrived on the scene.

CLICK HERE to read about the 'hero teacher,' the principal and 20 children who lost their lives.

The audience showed no signs of impatience, despite the delayed start. They sat quietly until a group of state police arrived at the already packed high school auditorium, but then stood to give the police a standing ovation and hugs.

A short time later more police arrived, and were also greeted with applause and hugs.

Assuming a consoling role that has become all too familiar for this presidency, Obama will also privately meet with some of the families affected by the tragic shooting, as well as local first responders.

The president has witnessed five mass shootings since assuming office in 2009, his reaction to this most recent tragedy in New England being his most publicly emotional. On Friday, tears collected in his eyes as he addressed the nation after the tragedy.

"The majority of those who died today were children, beautiful little kids between the ages of 5 and 10 years old," the president said, pausing to collect himself. "They had their entire lives ahead of them -- birthdays, graduations, weddings, kids of their own."

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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)

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Body found in Singapore River

SINGAPORE: A man was found dead in the Singapore River along Clarke Quay early Sunday morning.

The Singapore Civil Defence Force (SCDF) said it received a call at about 1.30am.

Someone was spotted jumping into the river near Block A.

SCDF officers arrived about four minutes later and conducted a search around the area.

Diving at a depth of about 3 metres, rescuers retrieved the body of a man about three-and-a-half hours later.

He was pronounced dead at the scene.

Police are investigating the unnatural death.

- CNA/ir

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Haryana residents prefer khaps over courts: Report

CHANDIGARH: A survey carried out by a sub-committee constituted by Haryana Backward Class Commission (HBCC) to ascertain possibility of reservation for jats and other communities has found out that rustic Haryanvis have more faith in social panchayats than judicial courts and prefer to approach khaps for remedial measures.

During the survey conducted on 49,870 households in rural areas, it was found that 66.6% families from 16 different castes said they preferred approaching khap panchayats than opting for judicial remedies for seeking justice whenever disputes arise. The survey was tasked to ascertain khaps' influence in Haryana and was conducted by a sub-committee headed by K S Sangwan, a former HoD of department of sociology at Maharishi Dayanand University, Rohtak.

The research was one of the 12 social indicators used by the sub-committee for determining social, educational and economical backwardness of various castes and communities of Haryana. While this part of the report has come as a shot in the arm for khap leaders, who claim khap panchayat to be legitimate dispute disputes platform, they have very conveniently chosen to trash the rest of the report.

"This is the only portion where the commission could not manipulate. We cannot rely on any other recommendations made in the report,'' said Sube Singh Samain, a spokesperson of Sarvjat Khap Panchayat.

Khaps in Haryana have been inviting criticism from various sections of the society as well as Punjab and Haryana High court for their diktats on barring same-village marriages and inter-caste marriages, which has led to incidents of honor killings in the state.

"Bhaichara (brotherhood) concept still exists in rural Haryana. Khaps have played important role in solving common problems. Villagers feel that in courts only one party wins the case. But when it comes to khap panchayats, it is a win-win situation for both the parties,'' said Sangwan.

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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."

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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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