Gunman's Computer Damaged, Drive Possibly Ruined

A computer at the Connecticut home where Newtown, Conn., school shooter Adam Lanza lived with his mother was badly damaged, perhaps smashed with a hammer, said police who hope the machine might still yield clues to the gunman's motive.

The computer's hard drive appeared to have been badly damaged with a hammer or screw driver, law enforcement authorities told ABC News, complicating efforts to exploit it for evidence.

Officials have "seized significant evidence at [Lanza's] residence," said Connecticut State Police spokesman Paul Vance, adding that the process of sifting through that much forensic evidence would be a lengthy and "painstaking process."

Authorities also told ABC News that the weapons used in Friday's rampage at Sandyhook Elementary School, which left dead 20 children and seven adults including Lanza's mother Nancy, were purchased by his mother between 2010 and 2012.

According to the Bureau of Alcohol Tobacco and Firearms, Lanza visited shooting ranges several times in recent years, and went at least one time with his mother.

The first funeral for a child killed in the massacre was held today in Fairfield, Conn., where mourners gathered to remember the too-short life of first-grader Noah Pozner.

Authorities also revealed this morning that two adult women shot during the rampage survived and their accounts will likely be integral to the investigation.

"Investigators will, in fact, speak with them when it's medically appropriate and they will shed a great deal of light on the facts and circumstances of this tragic investigation," Connecticut State Police Lt. Paul Vance said at a news conference today.

Both survivors are women and are now home from the hospital after being shot, police said. Officials had previously mentioned just one adult survivor. The women have not been identified and police did not give details on their injuries.

READ MORE: School nurse hid from gunman.

Both adults, Vance said, were wounded in the "lower extremities," but did not indicate where in the building they were when they were injured.

Moving trucks were seen outside Sandy Hook Elementary School this morning, as school officials prepare to move furniture and supplies to a vacant school in neighboring Monroe.

Sandy Hook itself will remain a secure crime scene "indefinitely," said Vance.

Emily Friedman/ABC News, Handout

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CLICK HERE for complete coverage of the tragedy at Sandy Hook.

Police say Adam Lanza, 20, forced his way into Sandy Hook Elementary School on Friday, spraying bullets on students and faculty. Lanza killed 20 children and six adults before turning the gun on himself.

Lanza also killed his mother Nancy Lanza at the home they shared before going to school.

"There are many, many witnesses that need to be interviewed," Vance said. "We will not stop until we have interviewed every last one of them."

Vance said the investigation could take weeks or months to complete. "It's not something done in 60 minutes like you see on T.V."

Some of the other key witnesses will be children who survived the shooting spree by playing dead, hiding in closets and bathrooms and being rescued by dedicated teachers.

"Any interviews with any children will be done with professionals...as appropriate," Vance said. "We'll handle that extremely delicately when the time arises."

CLICK HERE for a tribute to the shooting victims.

The first funerals for victims of the shooting are today, beginning with 6-year-olds Noah Pozner and Jack Pinto.

Officials said today that the Sandy Hook Elementary School, where the shooting took place, will be closed "indefinitely."

Both the school and the home where shootings took place are being held by police as crime scenes and Vance predicted authorities would spend "months" investigating the elementary school.

All Newtown schools are closed today to give residents more time to cope. Every school except for Sandy Hook is expected to re-open Tuesday.

The town of Monroe has offered to open to Sandy Hook students the Chalk Hill School, a former middle school that currently houses the town's EMS and recreational departments.

Officials in Monroe, less than 10 miles from Newtown, say the building could be ready for students by the end of the week, but have not yet set a date to resume classes.

Nearly 100 volunteers are working to ensure the building complies with fire and security regulations and are working to retorfit the school with bathroom facilities for young children.

"We're working to make the school safe and secure for students," said Monroe Police Department spokesman Lt. Brian H. McCauley.

The neighboring community's school is expected to be ready to accommodate students in the next few days, though an exact schedule has not yet been published.

While the families grieve, federal and state authorities are working around the clock to answer the question on so many minds: "Why?"

ABC News has learned that investigators have seized computers belonging to Adam Lanza from the home he shared with his mother. Three weapons were found at the school scene and a fourth was recovered from Lanza's car. Lanza had hundreds of rounds and used multiple high-capacity magazines when he went on the rampage, according to Connecticut State Police.

Vance said that every single electronic device, weapon and round will be thoroughly examined and investigated as well as every aspect of Lanza's life going "back to the date of birth."

ABC News has learned that both the shooter and his mother spent time at an area gun range; however it was not yet known whether they had shot there.

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Clinton gets accountability report on Benghazi attacks

WASHINGTON (Reuters) - Secretary of State Hillary Clinton on Monday received an official review of the September attack on a U.S. diplomatic mission in Benghazi, Libya, setting the stage for testimony on an incident that prompted a political furor and sharp questions about security at U.S. diplomatic facilities overseas.

The State Department said Clinton - who is convalescing after suffering a concussion last week - received the report from the Accountability Review Board formed to probe the attack which killed U.S. Ambassador Christopher Stevens and three other Americans.

"The ARB has completed its work. Its report has gone to the secretary this morning. She now has it," State Department spokeswoman Victoria Nuland said.

The committee has been meeting in private and State Department officials have declined to discuss almost all specifics of the Benghazi attack pending its reports.

The findings are expected to cover questions on whether enough attention was given to potential threats and how Washington responded to security requests from U.S. diplomats in Libya.

A determination that top State Department officials turned down those requests, as Republican congressional investigators allege, could refuel criticism of the officials - and possibly even end the careers of some of them.

Clinton had been expected to testify to Congress on December 20 on the report's results, but is under doctors' orders to remain at home this week.

Deputy Secretary William Burns and Deputy Secretary Thomas Nides will testify in her stead at Thursday's open hearings of the Senate and House foreign affairs committees, Nuland said.

Prior to that, the Accountability Review Board's two leaders - retired Ambassador Thomas Pickering and retired chairman of the U.S. Joint Chiefs of Staff Michael Mullen - will testify in closed door hearings of the two committees on Wednesday, she said.

POLITICAL FALLOUT

The political uproar over the September 11 Benghazi attack has already claimed one victim.

U.S. Ambassador to the United Nations Susan Rice, widely tipped as a front-runner to replace Clinton when she steps down as secretary of state early next year, last week withdrew her name from consideration, saying she wished to avoid a potentially disruptive Senate confirmation process.

Republican lawmakers had blasted Rice for televised comments she made in the aftermath of the attack in which she said preliminary information suggested the assault was the result of protests over an anti-Muslim video made in California rather than a premeditated strike.

Rice has said she was relying on talking points drawn up by U.S. intelligence officials.

Nuland said the final report could contain both classified and unclassified sections, and that only the latter would be made publicly available.

Central questions raised include why the ambassador was in such an unstable part of Libya on the anniversary of the September 11, 2001, attacks on New York and the Pentagon.

The five-person independent board usually includes retired ambassadors, a former CIA officer and a member of the private sector. It has the power to issue subpoenas, and members are required to have appropriate security clearances to review classified information.

Nuland said that Clinton - who intends to step down toward the end of January when President Barack Obama is sworn in for his second term - was "on the mend" following her concussion, which occurred when she fell as a result of dehydration due to a stomach virus.

She added that Clinton remained open to discussing the attack with lawmakers herself next month.

"She looks forward to continuing to engage with them in January and she will be open to whatever they consider appropriate in that regard," Nuland said. (Editing by Warren Strobel and Mohammad Zargham)

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Tokyo stocks up 1.62% after LDP win in Japan polls

TOKYO: Tokyo stocks soared 1.62 per cent at the open on Monday after Japan's conservative opposition swept to victory in national polls, with promises from its leader to press for more central bank easing.

The benchmark Nikkei 225 index added 158.12 points to 9,895.68 at the start of trade, as the yen plunged in the wake of the Liberal Democratic Party's landslide win over the ruling Democratic Party of Japan.

- AFP/fa

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NRI marriage, anti-smuggling Acts to be tabled in Punjab assembly

CHANDIGARH: Short "vacation marriages" resulting from Punjab's puritan social mindset and preference of NRI grooms over the desi counterparts are set to find a permanent halt.

Two legislations -- Compulsory registration of marriage act for NRIs and Punjab prevention of human smuggling act -- will be tabled when the Punjab assembly begins on Monday. The bills will put an end to trauma that has been faced by over 12,000 women in Punjab deserted by their NRI husbands since 1998.

"This first of its own kind law would tighten the noose of grooms against fraud marriages as it would be mandatory for NRIs to register their marriage, their full details of lives abroad and their address in India," Punjab NRI and public relations minister Bikram Majithia told TOI.

The marriage bill, Punjab Compulsory Registration of Marriages Bill 2008, has taken four years after it was first passed, paving the way for registration of marriages solemnized in the state under the Anand Marriage Act, 1909.

According to a recent overseas ministry report, a copy of which is with TOI, Punjab, Delhi and Andhra Pradesh reported the highest number of complaints in the country in 2011, from Indian brides against their NRI husbands. While 101 complaints were registered against spouses from Punjab, Delhi and Andhra Pradesh reported 74 and 42 cases respectively.

According to another report by National Commission for Women (NCW), the maximum number of these complaints have been registered with grooms from Canada, US and Australia (in the same order).

The second bill on smuggling Act, would make it compulsory for travel agents to register themselves with the competent authority of Punjab government. When the Act is enforced, Punjab would be the first state in the country to put an end to illegal practices of unauthorized travel agents.

"The smuggling Act would encourage youngsters to go abroad through proper and legal channel," said Majithia.

FIRs against NRI grooms

2011: 74

2010: 85

2009: 67

2008: 72

(Under Section 498A of domestic violence)

Punjab NRIs

UK: 3,00,000

US: 2,50,000

Canada 2,78,400

Malaysia: 1,00,000

Africa: 1,00,000

UAE: 70,000

(Source: Ministry of overseas affairs)

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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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Photos: Conn. Community in Sorrow After School Shooting

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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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Cautious Obama faces gun control pressure after school shooting

WASHINGTON: The latest mass shooting in the United States - this time with 20 children among the dead - is triggering a deluge of calls for President Barack Obama to address gun control, a politically sensitive issue which he avoided during his first term in the White House.

With the nation in shock over the carnage on Friday, Obama went on television and wiped away tears as he mourned the slain, which included six adults killed at the Newtown, Connecticut, elementary school and another elsewhere.

The president stressed he was particularly saddened as a parent. He and wife Michelle have two young daughters.

"We have to come together and take meaningful action to prevent more tragedies like this," Obama said in his weekly radio address on Saturday. "Regardless of the politics."

He did not go into details, however, and proponents of gun control are getting impatient.

"The country needs (Obama) to send a bill to Congress to fix this problem," said New York Mayor Michael Bloomberg. "Calling for 'meaningful action' is not enough. We need immediate action. We have heard all the rhetoric before."

White House spokesman Jay Carney said on Friday it was too early to address the issue. "There is I'm sure - will be, rather, a day for discussion of the usual Washington policy debates, but I don't think today is that day," Carney said.

People reacted quickly. "Today is the day," read banners held by activists outside the White House in a vigil within hours of the school shooting.

A petition for tougher gun control legislation had more than 80,000 signatures on the White House website Saturday.

The Connecticut killings are unspeakably gruesome because such small children were involved.

But they are not the first such massacre under Obama's watch.

In January 2011 in Arizona six people died at the hands of a shooter targeting Democratic Representative Gabrielle Giffords, who took a bullet in the head but survived.

This summer 12 people were shot in Colorado during a midnight screening of a Batman movie.

Obama visited both cities and spoke of the need to crack down on gun violence. He promised to work with Congress and achieve a consensus.

But that is all. His timidity on the issue has been attributed to wariness of alienating voters who believe their constitutional right to bear arms is sacred, deserves a broad interpretation and is not to be touched.

The gun buff and manufacturers lobby, the National Rifle Association, is very critical of Obama even though he has done little that goes against its platform. Its pockets are deep, and it tries to influence local elections. Both Democrats and Republicans are wary of tangling with it.

But after winning re-election in November, Obama will not face the voters again and Jonathan Lowy, director of the Brady Center's Legal Action Project, said the NRA is nothing to fear.

"President Obama and other Democrats have really misread and overestimated the strength of the gun lobby," said Lowy, whose organisation is named for James Brady, the White House press secretary who was shot and left disabled in an assassination attempt on then president Ronald Reagan in 1981.

"The fact is they have very loud bark, but they have very little bite," he told AFP on Saturday.

"In the past election, they (the gun lobby) spent a lot of money - 99 percent of it was towards losing candidates, and that holds true in virtually every election cycle," Lowy said. "They spend a lot of money, they make a lot of noise and their candidates lose, so they really are not a force to be afraid of."

Left-leaning or moderate news outlets also urged the president to take action.

"Obama told the nation that he reacted to the shootings in Newtown 'as a parent,' and that is understandable, but what we need most is for him to act as a President, liberated at last from the constraints of elections and their dirty compromises - a president who dares to change the national debate and the legislative agenda on guns," David Remnick wrote in The New Yorker.

- AFP/de

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Kargil martyr's father counters Malik's claim

CHANDIGARH: Kargil hero Captain Saurabh Kalia's father Dr N K Kalia on Saturday claimed that he has evidence which proves that his son and five other jawans were tortured after they were captured by the Pakistan troops, a day after Pakistan interior minister Rehman Malik suggested that Captain Kalia could have died of adverse weather.

As evidence, he referred to the announcement made by Pakistan radio in May 1999 that Pakistan army had arrested one officer and five soldiers of Indian army, following which the then DG (military operations) Lt Gen N C Vij had taken up the issue with his counterpart in Pakistan.

"I am surprised why our Army is not contesting the lies of Rehman Malik, as the Army headquarters is in possession of all such records, including preliminary investigation of Saurabh's body at Kargil, full report of autopsy and video recording of his entire body," Dr Kalia, a retired scientist from Council of Scientific and Industrial Research, said.

He added that it is high time the Army handed over all the relevant documents to the visiting minister. "If weather was responsible for Saurabh's death, then who fired at him? How is it that the private parts and limbs of Saurabh's body were chopped off? How his eyes were gorged out and bones broken," asked Dr Kalia.

"I am a retired scientist and can differentiate between the cause of death due to weather and torture," he said, adding that he is in possession of edited report of Saurabh's autopsy provided by the Army headquarters.

"I have no remorse for losing my son in battle but it is disgusting to see the brutal treatment given by the Pakistan troops after taking him into their custody. My fight is not for my son alone but for the dignity of all the soldiers of the armed forces," Kalia said.

The Supreme Court on Friday had said that the doors were still open for the Union government to move the International Court of Justice on gross human rights violations by Pakistani soldiers in torturing Captain Kalia before killing him and handing back his mutilated body.

Meanwhile, Malik on Saturday tried to assuage outrage over his remarks on torture meted out to Kargil hero Saurabh, saying he will look into the case.

Malik claimed that India has never raised the Saurabh issue with Pakistan in the last 15 years.

"If the Pakistani Army has tortured him, why would have they given his dead body. There have been many things to it. His father wants to take the matter to International Court of Justice. On Friday, during the meeting for the first time I was asked to look into the matter," he said.

"I promised them that please give me the detail. I will return and will look into the matter and revert with detailed information. I sympathise with his father," he added.

The minister reiterated that he was not sure whether Kalia died of a bullet or bad weather in Kargil.

"I said that Kargil is full of snow. I said I don't know whether he died of a bullet or because of any other reason or weather. So no negativity of any kind should be brought into it," he said.

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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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