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)

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Football: Real Madrid held by Espanyol, pressure builds on Mourinho

MADRID: A late goal from substitute Juan Albin gave Espanyol a 2-2 draw against stuttering Real Madrid who will be 13 points off La Liga leaders Barcelona if they beat second-placed Atletico Madrid later Sunday.

The pressure is now firmly on coach Jose Mourinho with the reigning champions unable to beat relegation-threatened Espanyol.

Cristiano Ronaldo equalised for Madrid on the stroke of half-time after Sergio Garcia had put joint-bottom Espanyol ahead on the half hour mark.

Two minutes after the restart, Fabio Coentrao put Real ahead but it was not enough as Albin slotted home from close range two minutes from the end.

Mourinho had already criticised his players for a lacklustre performance in a midweek Spanish Cup game where they lost to Celta Vigo.

He will be even more frustrated after his side failed to wrap up Sunday's game.

Barcelona have won 14 of their first 15 games in a record start in La Liga and a win against Atletico would be a significant blow in the title race.

Jose Callejon was given the job of leading the Real line with Gonzalo Higuain and Karim Benzema both injured.

Angel Di Maria, who is widely believed to be one of the players that Mourinho was referring to for not giving their all against Celta, started on the bench.

Madrid pressed forward from the start with Ronaldo firing past the post from 25 yards and then moments later poking a pass to Luka Modric who should have at least hit the target with a shot inside the area.

New Espanyol coach Javier Aguirre has worked hard on making the defence more solid but he was without captain and first choice keeper Cristian Alvarez and so put his faith in the inexperienced Francisco Casilla to cope with the intimidating Bernabeu.

Casilla first parried a Ronaldo shot and then Pepe wasted an excellent opening when he headed a Mesut Ozil cross straight at him.

There were warning signs at the other end when Simao struck a weak effort when well placed on the left of the area and then Garcia failed to connect with a long ball from playmaker Joan Verdu which would have put him clear on goal.

Modric hit the post for Madrid with a long distance drive midway through the first half while Wakaso Mubarak was pulled off by the Espanyol coach after some wild challenges having already been booked.

Garcia put the visitors ahead with a clinical finish from a Verdu pass that split the Madrid defence and silenced the crowd.

Ronaldo was denied again by Casilla before he did finally put the ball in the back of the net as he knocked in a cross from Sami Khedira.

After the break Madrid had more of a cutting edge and Coentrao, bursting forward from full-back, latched onto a Ronaldo pass and slotted the ball past Casilla.

The Espanyol shot-stopper was in inspired form though as he prevented Madrid from killing off the game by denying Callejon and substitute Di Maria before also tipping a powerful strike from the latter onto the crossbar.

Madrid were made to rue their missed chances as Albin knocked the ball in after a goalmouth melee as the home side desperately sought to clear the ball.

Earlier, Valencia suffered their first defeat under coach Ernesto Valverde as they fell 1-0 at home to Rayo Vallecano.

Chori Dominguez scored from the penalty spot after Tino Costa upended Roberto Trashorras.

A first-half strike from Ruben Garcia gave Levante a 1-0 win away to Zaragoza.

- AFP/fa

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Narrow escape for 250 as 2 jets come close to collision

KOLKATA: More than 250 people had a narrow escape as two aircraft came within sniffing distance of each other off the Andhra Pradesh coast. One aircraft was flying to Chennai from Kolkata while the other one was flying to Visakhapatnam from Mumbai via Hyderabad.

The two Boeing 737-800s came 5km of each other on Saturday, a fourth of the minimum stipulated distance that aircraft must maintain in the air as they came on converging paths 41,000 feet above the Bay of Bengal.

For six tense, nail-biting minutes the anti-collision warning systems in both aircraft activated and monitors at Kolkata airport's control room showed the two dots converging at a spot 340km from Kolkata at 11.55pm. The controllers sat glued to the screens and barked instructions into the radio. Another chartered flight from Mumbai and was possibly heading for Hyderabad meant the controllers had to extremely careful. In the cockpits of the two planes, alarmed pilots sent SOSs to the controller.

The planes came so perilously close because the Kolkata controller spotted the Visakhapatnam-bound flight only after it entered Kolkata airspace. The Chennai-bound flight was already flying in Kolkata airspace and was instructed to descend to 35,000 feet. Both aircraft in Saturday's close shave were under radar coverage and belonged to the same private carrier.

Passengers on board the two flights were, however, unaware of the situation. The Directorate General of Civil Aviation will conduct a probe.

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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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Threat Forces Evacuation of Conn. Church

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

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

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

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

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

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

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

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

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

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

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

Connecticut Shooting: Churches Services Honor Victims Watch Video

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

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

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

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

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

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

One says "Rest in Peace Sweet Angels."

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

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

READ: Complete List of Sandy Hook Victims

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

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

Police Tracing Guns Used in Shooting

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

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

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

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

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

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

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Egyptians vote on divisive constitution

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

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

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

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

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

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

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

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

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

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

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

TRANSITION

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

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

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

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

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

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

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

TWO DAYS

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

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

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

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

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

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US police seek clues in school shooting

NEWTOWN, Connecticut: US police indicated on Saturday they are homing in on the mystery of what triggered the massacre of 20 children and six adults at a school by a young lone gunman.

Police have yet to make public the identities of the dead or almost any of the details of what happened inside Sandy Hook Elementary School just after classes started Friday.

The motives of the shooter, identified by US media as 20-year-old Adam Lanza, were the biggest mystery.

But Connecticut State Police spokesman Lieutenant Paul Vance said detectives in Newtown, a picturesque small town north-east of New York City, had begun to "peel back the onion."

Asked whether any suicide note, emails or other clues to the killer's mind had been found, he said the crime scene "did produce some very - very good evidence in our investigation."

"Investigators will be able to use (this) in hopefully painting the complete picture as to how and more importantly why this occurred," he told a news conference.

Bodies were removed from the blood-soaked school overnight Saturday and relatives were privately given formal identification of the dead.

In addition to the dead in the school, police found a woman's body in the house where Lanza and his mother were believed to have lived.

News reports quoted police saying she was Lanza's mother and that he'd shot her in the face before heading to the school, armed at least with two semi-automatic pistols and a military grade rifle - all registered in his mother's name.

At the school, where a black-clad Lanza concentrated his fire on just two rooms, the child victims were aged between five and 10. Among the dead adults were the school principal.

A new security system had been recently installed, but Vance said the shooter forced his way in to the school.

Police then entered from several points, breaking "many windows" as they frantically tried to get survivors out and to locate the gunman.

Mary Ann Jacob, who works in the school library, told reporters Saturday that she had sheltered 18 children during the mayhem.

"We were locked in our room," she said. "It was hard to keep them quiet. We told them it was a joke. I think they didn't really know what was going on."

Amid a flurry of rumours about how the murders played out, NBC reported that Lanza may have had an altercation earlier with four school staff, and that three of them were among the slain.

Late Friday, as darkness fell over the town, locals gathered for a church vigil, spilling onto the street in large numbers.

"This is a kind of community, when things like that happen, they really pull together," the priest, Robert Weiss, said during the Roman Catholic Mass.

A letter from Pope Benedict XVI was also read during the service.

The pope "has asked me to convey his heartfelt grief and the assurance of his closeness in prayer to the victims and their families, and to all affected by the shocking event," Vatican Secretary of State Tarcisio Bertone said.

"Our faith is tested," state Governor Dan Malloy told the congregants. "Not just necessarily our faith in God, but our faith in community, and who we are, and what we collectively are."

President Barack Obama, wiping away tears and struggling to maintain his composure, said Friday he was aghast over the tragedy.

There were similar statements of grief and shock around the world.

The head of the European Commission, Jose Manuel Barroso, spoke of his "deep shock and horror," Britain's Queen Elizabeth II sent a message to Obama in which she said she was "deeply shocked and saddened," and French President Francois Hollande expressed his condolences to Obama, saying the news "horrified me."

Of all US campus shootings, the toll was second only to the 32 murders in the 2007 massacre at Virginia Tech university.

The latest number far exceeded the 15 killed in the 1999 Columbine High School massacre, which triggered a fierce but inconclusive debate about the United States' relaxed gun control laws.

However, the White House on Friday scotched any suggestion that the politically explosive subject would be quickly reopened.

- AFP/de

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Rs 600/month enough to feed family of 5: Sheila Dikshit

NEW DELHI: They listened to chief minister Sheila Dikshit in silence but couldn't hide their disbelief. Speaking on the occasion of the launch of Delhi government's cash-for-food programme, Annshree Yojana, on Saturday, Dikshit argued that Rs 600 - the cash subsidy - was adequate for buying the monthly "dal, roti and chawal" for a poor family of around five. UPA chairperson Sonia Gandhi was on the stage at Thyagaraja Stadium to launch the scheme.

Many of the voiceless beneficiaries - who had been herded into the stadium to witness the launch of the scheme which UPA believes will be a game-changer - couldn't swallow this glib remark. As they trooped out of the venue, long after the applause had died down, the women whom the scheme seeks to empower said they didn't need to do any sums to tell you that rations for families with five to seven members would come for Rs 1000-Rs 3000.

Asked if Rs 600 was enough, women from a slum in west Delhi said they were under siege - illness, lack of shelter, inflation. The amount of Rs 600 was nothing but a 'sahara' (support), said Maya Devi.

'Cash will give people choice'

"Something is better than nothing,"remarked others. Another woman, Ganga Devi, said she spends Rs 3000 on rations every month for a family of seven. "How can I manage it in Rs 600? This is just a support," she agreed.

Radha from Rohini showed a bank passbook of her no-frills account and her Aaadhar-UID card to prove that she was indeed a beneficiary. Her husband, Ravi Singh, a daily wager stood next to her. Asked how the couple would use the money, Radha was candid. "I will spend it on the most urgent needs of the family," she said.

Experts involved in the planning for the scheme feel that the Rs 600 subsidy will have to be eventually enhanced if one was to be realistic. The scheme seeks to empower the eldest woman of the beneficiary family with a no-frills account where the subsidy will be delivered every month based on the Aadhar-UID number as identity proof. Announcing that Delhi government had set aside Rs 200 crore for funding the Annshree subsidy, the CM said the scheme will ensured that no one goes hungry.

"We got a voluntary organization to carry out a study in the target population to see if people wanted cash or ration. We found that 99% people wanted cash as women felt it would give them the freedom to buy what they need. For instance, some women said they could buy medicines if a family member was ill," Dikshit added.

About 13,300 people will benefit from the scheme with immediate effect and the government has a target to register a total of 2 lakh beneficiaries. These are being chosen from a state survey of most vulnerable carried out in 2009. The scheme applies only to those who do not get the benefit of subsidized rations under PDS. All beneficiaries will get the subusidy from April 1, 2012 onwards.

Cash transfer later in districts not prepared: FM

If any of the 51 districts selected by the Centre for the rollout of the direct cash transfer programme from January 1 are not ready with their infrastructure by the end of this year, they will be taken up only later, finance minister P Chidambaram said in Alwar on Saturday. He was addressing concerns that the government seemed to be pushing ahead with a scheme that many local administrations were not ready for.

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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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Conn. Shooting: Cops Probe Report of Earlier Altercation

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

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

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

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

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

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

Emmanuel Dunand/AFP/Getty Images

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

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

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

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

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

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

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

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

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

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

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

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