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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Stock futures signal flat to higher open

PARIS (Reuters) - Stock pointed to a flat to higher open on Wall Street on Monday, with futures for the S&P 500 up 0.09 percent, Dow Jones futures up 0.04 percent and Nasdaq 100 futures down 0.01 percent at 4:57 a.m. ET.


* European stocks dipped on Monday, as the first signs of movement from Republicans in U.S. budget talks failed to convince investors, who booked some profit on a brisk four-week rally.


* A landslide election victory for Japan's Liberal Democratic Party, however, sparked recovery hopes for the world's third-biggest economy and sent the Nikkei <.n225> to a near 9-month high.


* Republican House Speaker John Boehner edged closer to President Barack Obama's key demands as they try to avert the "fiscal cliff" of tax hikes and spending cuts set to take effect unless Congress intervenes by December 31.


* Apple Inc will be in the spotlight after the company said it has sold more than 2 million of its new iPhone 5 in China during the three days after its launch there on Friday, marking China's best-selling iPhone rollout ever.


* Citigroup cuts its rating on Apple shares to 'neutral' from 'buy' and slashes its price target to $575 from $675.


* Google may not face any major repercussions from the Federal Trade Commission's (FTC) two-year-old anti-trust investigation into its web search business, the Wall Street Journal reported, citing people familiar with the matter.


* KKR & Co L.P. has finished raising $6 billion for its second pan-Asia fund, according to sources, the largest private equity pool ever assembled for the region, with strong demand from pension funds and endowments seeking emerging market returns.


* American International Group Inc may raise as much as $6.5 billion from the sale of its remaining stake in AIA Group Ltd in Asia's second-largest block sale ever, exiting a business the U.S. insurer started nearly 100 years ago.


* Networking equipment company Cisco Systems Inc has hired Barclays to sell its Linksys home router unit, a report said on Sunday.


* U.S. stocks fell on Friday as another slide in Apple took a toll and investors unloaded some shares because of the uncertainty surrounding the "fiscal cliff" negotiations.


* The Dow Jones industrial average <.dji> slipped 35.71 points, or 0.27 percent, to 13,135.01 at the close. The Standard & Poor's 500 Index <.spx> fell 5.87 points, or 0.41 percent, to 1,413.58. The Nasdaq Composite Index <.ixic> lost 20.83 points, or 0.70 percent, to close at 2,971.33.


(Reporting by Blaise Robinson; editing by Patrick Graham)



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Egyptians narrowly back constitution, say rival camps


CAIRO (Reuters) - Egyptians voted narrowly in favor of a constitution shaped by Islamists but opposed by other groups who fear it will deepen divisions, officials in rival camps said on Sunday after the first round of a two-stage referendum.


Next week's second round is likely to give another "yes" vote as it includes districts seen as more sympathetic towards Islamists, analysts say, meaning the constitution would be approved.


But a close win, if confirmed, would give Islamist President Mohamed Mursi only limited cause for celebration as it would show a wide rift in a country where he needs to build consensus on tough measures to fix a fragile economy.


The Muslim Brotherhood's party, which propelled Mursi to office in a June election, said 56.5 percent backed the text. Official results are not expected till after the next round.


Mursi and his backers say the constitution is vital to move Egypt's democratic transition forward. Opponents say the basic law is too Islamist and tramples on minority rights, including those of Christians who make up 10 percent of the population.


The build-up to Saturday's vote was marred by deadly protests. Demonstrations erupted when Mursi awarded himself extra powers on November 22 and then fast-tracked the constitution through an assembly dominated by his Islamist allies.


However, the vote passed off calmly with long queues in Cairo and several other places, though unofficial tallies indicated turnout was around a third of the 26 million people eligible to vote this time. The vote was staggered because many judges needed to oversee polling staged a boycott in protest.


The opposition had said the vote should not have been held given violent protests in the Arab world's most populous nation, which is watched closely from abroad to see how Islamists, long viewed warily in the West, handle themselves in power.


"It's wrong to have a vote or referendum with the country in the state it is - blood and killings, and no security," said Emad Sobhy, a voter who lives in Cairo. "Holding a referendum with the country as it is cannot give you a proper result."


INCREASINGLY DIVIDED


As polls closed, Islamists attacked the offices of the newspaper of the liberal Wafd party, part of the opposition National Salvation Front coalition that pushed for a "no" vote.


"The referendum was 56.5 percent for the 'yes' vote," a senior official in the Brotherhood's Freedom and Justice Party operations room set up to monitor voting told Reuters.


The Brotherhood and its party had representatives at polling stations across the 10 areas, including Cairo, in this round. The official, who asked not to be identified, said the tally was based on counts from more than 99 percent of polling stations.


"The nation is increasingly divided and the pillars of state are swaying," opposition politician Mohamed ElBaradei wrote on Twitter. "Poverty and illiteracy are fertile grounds for trading with religion. The level of awareness is rising fast."


One opposition official also told Reuters the vote appeared to have gone in favor of Islamists who backed the constitution.


The opposition initially said its exit polls indicated the "no" camp would win comfortably, but officials changed tack during the night. One opposition official in the early hours of Sunday said it would be "very close". There was no formal statement from the opposition National Salvation Front.


"Even if this result is correct, that does not mean that this constitution can pass, because it means more than 40 percent of the people didn't agree with it," said Issam Amin, speaking on a Cairo street and echoing the opposition line that the constitution needed consensus backing not a simple majority.


A narrow loss could still hearten leftists, socialists, Christians and more liberal-minded Muslims who make up the disparate opposition camp, which has been beaten in two elections since Hosni Mubarak was overthrown last year.


They were drawn together to oppose what they saw as Mursi's power grab and his constitution push. The National Salvation Front includes prominent figures such as ElBaradei, former Arab League chief Amr Moussa and firebrand leftist Hamdeen Sabahy.


If the constitution is approved, a parliamentary election will follow early next year. Opposition leaders say the Front could help unite the opposition for that poll after their divided ranks have split the vote in previous elections.


DEADLY VIOLENCE


But analysts question whether the opposition group in this form will survive until a parliamentary election. The Islamist-dominated lower house of parliament elected earlier this year was dissolved based on a court order in June.


Violence in Cairo and other cities has plagued the run-up to the referendum. At least eight people were killed when rival camps clashed during demonstrations outside the presidential palace earlier this month.


Several party buildings belonging to the Muslim Brotherhood's party have been burned by angry protesters in recent weeks. On Friday, a day before the vote, rival factions armed with clubs, knives and swords fought in Alexandria.


In order to pass, the constitution must be approved by more than 50 percent of those casting ballots. There are 51 million were eligible voters in the nation of 83 million.


Rights groups reported some abuses, such as polling stations opening late, officials telling people how to vote and bribery. But Gamal Eid, head of the Arab Network for Human Rights Information, said abuses were not enough to invalidate the vote.


"We accepted the referendum so we accept the result," said Ahmed Mohamed, a Cairene who backed the draft. "If the majority said ‘yes', so be it. I didn't see forgery where I voted."


Islamists have been counting on their disciplined ranks of supporters and on Egyptians desperate for an end to turmoil that has hammered the economy and sent Egypt's pound to eight-year lows against the dollar.


If the constitution is voted down in a second round, which now looks unlikely, a new assembly will 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.


(Additional reporting by Tamim Elyan, Shaimaa Fayed and Reuters Television; Writing by Edmund Blair and Giles Elgood; Editing by Andrew Heavens)



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Tumblr Users Flock to Mashable Comment Thread






Tumblr Is Down


When Tumblr went down Wednesday evening, users flocked to Mashable to express their rage and disbelief.


Click here to view this gallery.






[More from Mashable: Mysterious Package Addressed to Indiana Jones Arrives at UChicago]


Where were you the day that Tumblr went down? Whether you were at home, at work or on the move, it’s possible that you somehow ended up on Mashable. That was the case for thousands of Tumblr users, who, desperate for their GIF fix after a Tumblr outage on Wednesday, found themselves commenting on a Mashable story about the glitch.


Frustrated Tumblr frequenters left without a blogging platform transformed the comment thread on Mashable’s story into a makeshift Tumblr dashboard. Users gathered to commiserate, voice their anger and post GIFs to express their feelings. The micro-community that sprung up in the post made these the top comments on Mashable this week.


[More from Mashable: The Top Comments on Mashable This Week]


We recently renovated our commenting system to allow readers to embed video and images, a feature Wednesday’s commenters took full advantage of. By the time Tumblr was again functional, the story had accrued over 4,000 comments. Users traded domain names, discussed their blogs and, above all, bemoaned a lack of access to the site. YouTube user moviepimpdj posted a video of the rapidly moving comment thread.


This week we also saw major changes to Facebook’s privacy settings, with our readers feeling mixed emotions about the shift. The community mused on what 2013 might hold with respect to responsive design.


What were your favorite comments from the Mashable community this week? Get involved with the discussion by signing up for Mashable Follow. You could see your voice in our next weekly roundup!


Image courtesy of Flickr, kurichan+


This story originally published on Mashable here.


Tech News Headlines – Yahoo! News


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Donald Faison Marries Cacee Cobb















12/15/2012 at 08:25 PM EST







Cacee Cobb and Donald Faison


Dr. Billy Ingram/WireImage


It's official!

After six years together, Donald Faison and Cacee Cobb were married Saturday night at the Los Angeles home of his Scrubs costar Zach Braff.

Cobb's friend Jessica Simpson was a bridesmaid. Sister Ashlee Simpson also attended.

"What a happy day," Tweeted groomsman Joshua Radin, a singer, who posted a photo of himself with Faison and Braff in their tuxedos.

The couple got engaged in August 2011. At the time, Faison Tweeted, "If you like it then you better put a Ring on it," and Cobb replied, "If she likes it then she better say YES!!"

Since then, the couple had been hard at work planning their wedding. On Nov. 12, Faison, who currently stars on The Exes, Tweeted that they were tasting cocktails to be served on the big day.

"Alcohol tasting for the wedding!" he wrote, adding a photo of the drinks. "The [sic] Ain't Say It Was Going To Be Like This!!!"

This is the first marriage for Cobb. Faison was previously married to Lisa Askey, with whom he has three children. (He also has a son from a previous relationship.)

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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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Wall Street Week Ahead: Holiday "on standby" as clock ticks on cliff

NEW YORK (Reuters) - The last two weeks of December are traditionally quiet for stocks, but traders accustomed to a bit of time off are staying close to their mobile devices, thanks to the "fiscal cliff."


Last-minute negotiations in Washington on the so-called fiscal cliff - nearly $600 billion of tax increases and spending cuts set to take effect in January that could cause a sharp slowdown in growth or even a recession - are keeping some traders and analysts from taking Christmas holidays because any deal could have a big impact on markets.


"A lot of firms are saying to their trading desks, 'You can take days off for Christmas, but you are on standby to come in if anything happens.' This is certainly different from previous years, especially around this time of the year when things are supposed to be slowing down," said J.J. Kinahan, chief derivatives strategist at TD Ameritrade in Chicago.


"Next week is going to be a Capitol Hill-driven market."


With talks between President Barack Obama and House Speaker John Boehner at an apparent standstill, it was increasingly likely that Washington will not come up with a deal before January 1.


Gordon Charlop, managing director at Rosenblatt Securities in New York, will also be on standby for the holiday season.


"It's a 'Look guys, let's just rotate and be sensible" type of situation going on," Charlop said.


"We are hopeful there is some resolution down there, but it seems to me they continue to walk that political tightrope... rather than coming up with something."


Despite concerns that the deadline will pass without a deal, the S&P 500 has held its ground with a 12.4 percent gain for the year. For this week, though, the S&P 500 fell 0.3 percent.


BEWARE OF THE WITCH


This coming Friday will mark the last so-called "quadruple witching" day of the year, when contracts for stock options, single stock futures, stock index options and stock index futures all expire. This could make trading more volatile.


"We could see some heavy selling as there is going to be a lot of re-establishing of positions, reallocation of assets before the year-end," Kinahan said.


RETHINKING APPLE


Higher tax rates on capital gains and dividends are part of the automatic tax increases that will go into effect next year, if Congress and the White House don't come up with a solution to avert the fiscal cliff. That possibility could give investors an incentive to unload certain stocks in some tax-related selling by December 31.


Some market participants said tax-related selling may be behind the weaker trend in the stock price of market leader Apple . Apple's stock has lost a quarter of its value since it hit a lifetime high of $705.07 on September 21.


On Friday, the stock fell 3.8 percent to $509.79 after the iPhone 5 got a chilly reception at its debut in China and two analysts cut shipment forecasts. But the stock is still up nearly 26 percent for the year.


"If you owned Apple for a long time, you should be thinking about reallocation as there will be changes in taxes and other regulations next year, although we don't really know which rules to play by yet," Kinahan said.


But one indicator of the market's reduced concern about the fiscal cliff compared with a few weeks ago, is the defense sector, which will be hit hard if the spending cuts take effect. The PHLX Defense Sector Index <.dfx> is up nearly 13 percent for the year, and sits just a few points from its 2012 high.


(Reporting by Angela Moon; Additional reporting by Chuck Mikolajczak; Editing by Jan Paschal)



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Egyptians vote on divisive constitution


CAIRO/ALEXANDRIA (Reuters) - Egyptians queued to vote on Saturday on a constitution promoted by its Islamist backers as the way out of a prolonged 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.


The liberal, secular and Christian opposition 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 president's authorities are less than before. He can't be a dictator."


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 an idea of the overall trend.


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.


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," Michael Nour, a 45-year-old Christian teacher in Alexandria. "The constitution does not represent all Egyptians," he said.


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


"I voted 'yes' for stability," said shopkeeper Ahmed Abou Rabu, 39. "I cannot say all the articles of the constitution are perfect but I am voting for a way forward. I don't want Egyptians to go in circles, for ever lost in this transition."


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.


One senior official in the committee overseeing the referendum said Saturday's vote could extend to Sunday if crowds were too heavy to allow everyone 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 they backed a "no" vote instead of a boycott.


Flag-waving Islamists gathered peacefully at one of the main mosques on Friday, some shouting "Islam, Islam" and "We've come here to say 'yes' to the constitution".


PALACE SIT-IN


Opposition supporters assembled outside the presidential palace, where there has been a sit-in for days. The walls of the palace, ringed by tanks, are scrawled with anti-Mursi graffiti.


The referendum will be held on two days covering different regions, with the second round on December 22, because there are not enough judges willing to monitor all polling stations after some in the judiciary 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 this year. 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 Andrew Heavens)



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5 YouTube Videos to Help Winterize Your Home






1. Caulk Talk



Westlake Ace Hardware gives a few basic steps, including caulking windows before the cold hits.






Click here to view this gallery.


[More from Mashable: Origami Self-Closing Stroller Is a Slick Gift for Techie Moms]


If you’re lucky, you’ll only feel a slight draft through a window crack. Maybe a gust of wind under the door. Either way, that Father Winter is one mean S.O.B.


Thankfully, there are easy steps you can take to make sure your home is ready for the winter season. Check out the gallery above to watch five YouTube videos with the most practical and cheapest tips for winterizing your house.


[More from Mashable: 12 Holiday Gift Ideas for Your Girlfriend]


Of course, those of you in warmer climates can ignore this advice. But for the folks gearing up for a snowy, wind-chilled couple of months ahead, we’ve got your back. And so does YouTube.


Any big tips we missed? Let us know below.


Image courtesy of Flickr, Jason Persse


This story originally published on Mashable here.


Tech News Headlines – Yahoo! News


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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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