Obama: Nation Faces 'Hard Questions' After Shooting













President Barack Obama said at an interfaith prayer service in this mourning community this evening that the country is "left with some hard questions" if it is to curb a rising trend in gun violence, such as the shooting spree Friday at Newtown's Sandy Hook Elementary School.


After consoling victims' families in classrooms at Newtown High School, the president said he would do everything in his power to "engage" a dialogue with Americans, including law enforcement and mental health professionals, because "we can't tolerate this anymore. These tragedies must end. And to end them we must change."






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









Sandy Hook Elementary Shooting: Remembering the Victims Watch Video







The president was not specific about what he thought would be necessary and did not even use the word "gun" in his remarks, but his speech was widely perceived as prelude to a call for more regulations and restrictions on the availability of firearms.


The grieving small town hosted the memorial service this evening as the the nation pieces together the circumstances that led to a gunman taking 26 lives Friday at the community's Sandy Hook Elementary School, most first graders.


"Someone once described the joy and anxiety of parenthood as the equivalent of having your heart outside your body all of the time, walking around," he said, speaking of the joys and fears of raising children.


"So it comes as a shock at a certain point when you realize no matter how much you love these kids you can't do it by yourself," he continued. "That this job of protecting kids and teaching them well is something we can only do together, with the help of friends and neighbors, with the help of a community, and the help of a nation."


CLICK HERE for Full Coverage of the Tragedy at Sandy Hook






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Absent Chavez dominates Venezuelan state elections


CARACAS (Reuters) - Venezuelans vote on Sunday in state elections that will define the future of opposition leader Henrique Capriles and test political forces ahead of a possible new presidential vote if Hugo Chavez is incapacitated by cancer.


The vote for 23 state governorships, of which the opposition controls seven, has been overshadowed by the president's battle to recover from cancer surgery in Cuba.


Yet it will have major implications for the unfolding political drama in the South American OPEC nation with the world's largest oil reserves.


Capriles, 40, must retain the governorship of Miranda if he is to remain the opposition's presidential candidate-in-waiting, while both sides will want a good showing to create momentum in case of a new showdown over who replaces Chavez.


"This is the best indication of how well the opposition will fare in an upcoming contest for the presidency between Henrique Capriles and designated Chavez dauphin Vice President Nicolas Maduro," said Russell Dallen of Caracas-based BBO Financial Services.


Whatever the private machinations going on, in public Maduro and other senior officials are focused only on Chavez's recovery after complications from Tuesday's operation in Havana.


It was a fourth surgery for the socialist leader since he was diagnosed with cancer in the pelvic region in mid-2011.


After re-election in October, Chavez, 58, is due to start a new term on January 10, but has named Maduro as his preferred successor should he be incapacitated.


That would trigger a new presidential poll within 30 days.


In its latest update, the government said Chavez had spoken to his family on Friday - possibly for the first time since surgery - and was recovering "satisfactorily" though slowly.


Few medical details have been released, so speculation is rife that Chavez may be in a life-threatening situation in Havana's Cimeq hospital with both a difficult post-operation recovery and a possible spreading of the cancer.


EMOTIONAL BACKDROP


In such a charged atmosphere, campaigning for Sunday's vote has taken a backseat to Catholic masses, prayer meetings and vigils across the nation for Chavez.


Maduro has wept in public, state media are replaying images of Chavez round-the-clock, and various government candidates held closing rallies simply playing the president's voice.


The sympathy factor could benefit Chavez's candidates and offset the disadvantage of losing his charismatic presence on the campaign trail in advance.


"Without wishing to be triumphalist, we have big chances of winning the 23 governorships and that is the biggest support we can give Chavez," said his brother Adan Chavez, who is seeking re-election in their hometown state of Barinas.


Still smarting from defeat in October, the opposition hopes voters will focus on grassroots issues and punish the government for power-cuts, pot-holed roads, corruption scandals, violent crime and runaway inflation.


"I put my life at the service of Miranda and Venezuela," Capriles said in his closing rally. "I'm not here to stay in power but to make a dream (of national change) come true."


Though widely expected to retain his Miranda seat, Capriles faces a well-financed challenge from senior Chavez ally Elias Jaua, a former vice president. If he defeats Capriles, it would leave the opposition in disarray and possibly spark in-fighting over who would be its next presidential candidate.


Two other opposition governors, Pablo Perez and Henri Falcon, are obvious possibilities. But first they too must retain their posts to maintain credibility, and they do not have the national recognition Capriles achieved during his unsuccessful run for the presidency in October.


Despite losing, he won the opposition's largest share - 6.5 million votes, or 45 percent - against Chavez, and impressed Venezuelans with his energetic style, visits to the remotest corners, and attention to their day-to-day issues.


"In the unlikely event that Capriles loses, he would probably have no chance of running for the presidency again," political risk consultancy Eurasia Group said.


The mid-December timing of the vote could count against the opposition, many of whose middle-class supporters often take advantage of school holidays to travel.


(Additional reporting by Marianna Parraga; Editing by Paul Simao)



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Resolution of stalled upgrading works at Rivervale Plaza one key priority: DPM






SINGAPORE: Deputy Prime Minister Teo Chee Hean has said that one of the priorities he wants to tackle for Punggol East residents is the resolution of upgrading works at Rivervale Plaza.

Works there have been delayed because the contractor has gone bust.

Mr Teo, who is also the anchor minister for Pasir Ris-Punggol GRC, was speaking to reporters on the sidelines of a community event on Sunday.

The Deepavali celebration is the second community event Mr Teo attended over the weekend, following the resignation of Punggol East MP Michael Palmer over an extramarital affair.

Mr Teo noted that one of the concerns of residents is the upgrading works at Rivervale.

He said his team of MPs will continue discussions, started by Mr Palmer, with the Housing and Development Board, residents and shop owners, to resolve the problem.

Mayor Teo Ser Luck has been appointed caretaker MP for Punggol East.

Mr Teo Chee Hean said: "We've always looked after the residents (of Punggol East) as a larger Pasir Ris-Punggol family. So I know quite a lot of the grassroots leaders here. I've been here many times also, with Mr Teo Ser Luck as well. So we will continue looking after residents."

DPM Teo has said he will attend the ward's Meet-the-People session on Monday night.

- CNA/ir



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ISRO to visit Leh to examine mysterious luminous objects

NEW DELHI: A team of scientists from Indian Space Research Organisation(ISRO) will soon arrive in Leh to further corroborate that the mysterious luminous objects seen on the horizon over a lake in Ladakh region of Jammu and Kashmir are actually "Chinese lanterns".

Official sources said today that after getting the preliminary report that the luminous objects flying over the horizon of Pangong lake, located 160km from Leh township, could be Chinese lanterns, the security agencies wanted an assessment of experts from another organisation for confirmation.

Therefore, it was decided to request ISRO to send a team of scientists to examine the flying objects and give its report, the sources said.

Indo-Tibetan Border Police(ITBP) had written to the government in October this year about sighting of some orange-yellow luminous flying objects on the horizon over the Pangong Lake. Besides, Leh-based 14-Corps was also alerted by the ITBP which reported to its Udhampur-based Northern Command.

After the incident, scientists from various organisations in consultation with experts of the IAF, whose radars were also unable to pick up any signal due to the flying of the unidentified objects on the horizon of the lake, came to a conclusion that it was Chinese lanterns.

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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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Conn. Victim's Father Remembers 'Loving' Daughter


ht emilie parker wy 121215 wblog Emilie Parker: Sandy Hook Victim Would Have Comforted Classmates, Dad Says

(Image credit: Emilie Parker Fund/Facebook)


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


“My daughter Emilie would be one of the first ones to be standing and giving support to all the victims because that’s the kind of kid she is,” her father, Robbie Parker said as he fought back tears, telling the world about his “bright, creative and loving” daughter who was one of the 20 young victims in the Newtown, Conn., shooting.


“She always had something kind to say about anybody,” her father said.  ”We find comfort reflecting on the incredible person Emilie was and how many lives she was able to touch.”


Emilie, 6, was helping teach her younger sisters to read and make things, and she was the little girls would go to for comfort, he said.


“They looked up to her,” Parker said.


READ: Complete List of Sandy Hook Victims


Parker moved his wife and three daughters to Newtown eight months ago after accepting a job as  a physician’s assistant at Danbury Hospital. He said Emilie, his oldest daughter, seemed to have adjusted well to her new school, and he was very happy with the school, too.


“I love the people at the school. I love Emilie’s teacher and the classmates we were able to get to know,” he said.


ap shock newton shooting sandy hook lpl 121214 wblog Emilie Parker: Sandy Hook Victim Would Have Comforted Classmates, Dad Says

      (Image Credit: Alex von Kleydorff/AP Photo)


The family dealt with another tragic loss in October when Emilie lost her grandfather in an accident.


“[This] has been a topic that has been discussed in our family in the past couple of  months,” Parker said. “[My daughters ages 3 and 4] seem to get the idea that there’s somebody who they will miss very much.”


Emilie, a budding artist who carried her markers and pencils everywhere, paid tribute to her grandfather by slipping a special card she had drawn into his casket, Parker said.  It was something she frequently did to lift the spirits of others.


“I can’t count the number of times Emilie would find someone feeling sad or frustrated and would make people a card,” Parker said. “She was an exceptional artist.”


The girl who was remembered as “always willing to try new things, other than food” was learning Portuguese from her father, who speaks the language.


ht emilie parker 2 121215 wblog Emilie Parker: Sandy Hook Victim Would Have Comforted Classmates, Dad Says

(Image Credit: Emilie Parker Fund/Facebook)


On Friday morning, Emilie woke up before her father left for his job and exchanged a few sentences with him in the language.


“She told me good morning and asked how I was doing,” Parker said. “She said she loved me, I gave her a kiss and I was out the door.”


Parker found out about the shooting while on lockdown in Danbury Hospital and found a television for the latest news.


“I didn’t think it was that big of deal at first,” he said. “With the first reports coming in, it didn’t sound like it was going to be as tragic as it was. That’s kind of what it was like for us.”


CLICK HERE for full coverage of the Sandy Hook shooting.


Parker said he knows that God can’t take away free will and would have been unable to stop the Sandy Hook shooting. While gunman Adam Lanza used his free agency to take innocent lives, Parker said he plans to use his in a positive way.


“I’m not mad because I have my  [free] agency to use this event to do whatever I can to make sure my family and my wife and my daughters are taken care [of],” he said. “And if there’s anything I can do to help to anyone at any time at anywhere, I’m free to do that.”


ht emilie parker 3 121215 wblog Emilie Parker: Sandy Hook Victim Would Have Comforted Classmates, Dad Says

(Image credit: Emilie Parker Fund/Facebook)


Friday night, hours after he learned of his daughter’s death, Parker said he spoke at his church.


“I don’t know how to get through something like this. My wife and I don’t understand how to process all of this,” he said today. “We find strength in our religion and in our faith and in our family. ”


“It’s a horrific tragedy and I want everyone to know our hearts and prayers go out to them. This includes the family of the shooter. I can’t imagine how hard this experience must be for you and I want you to know our family … love and support goes out to you as well.”

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Egyptians vote on divisive constitution


CAIRO/ALEXANDRIA (Reuters) - Egyptians voted 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.


Queues formed outside polling stations in Cairo and other cities and soldiers joined police to secure the referendum process after deadly protests during the build up. Street brawls again erupted on Friday in Alexandria, Egypt's second city.


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 president's 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 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."


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 Alexandria on Friday, tensions boiled over into a street brawl between rival factions armed with clubs, knives and swords. Several cars were set on fire and a Muslim preacher who had urged people to vote "yes" to the constitution was trapped inside his mosque by angry opposition supporters.


TRANSITION


Christians, making up about 10 percent of Egypt's 83 million people and who have long grumbled of discrimination, were among those queuing at a polling station in the port city 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. The constitution does not represent all Egyptians," said Michael Nour, a 45-year-old Christian school teacher in Alexandria.


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. (0600 GMT). He was shown on television casting his ballot shielded by a screen and then dipping his finger in ink - a measure to prevent people voting twice.


Polling stations close at 7 p.m. (1700 GMT), but the deadline could be extended depending on turnout.


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


Just over half of Egypt's electorate of 51 million will vote in the first round in Cairo and other cities.


To provide security for the vote, 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 on either side in the present crisis.


The charter has been criticized by some overseas bodies.


The International Council of Jurists, a Geneva-based human rights group, said it falls short of international standards on the accountability of the armed forces, the independence of the judiciary, and recognition of human rights.


United Nations human rights experts said the draft should be reviewed to ensure Egypt meets its obligations under international law on equality and women's rights.


(Writing by Edmund Blair and Giles Elgood; Editing by Andrew Heavens)



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NEA's new partnership to enhance S'pore's radiological operational readiness






SINGAPORE: National Environment Agency (NEA) and the Danish Emergency Management Agency (DEMA) have signed a Letter of Intent (LOI) on collaboration in nuclear and radiation safety, emergency preparedness and response.

NEA's partnership with DEMA is meant to enhance Singapore's capabilities in radiological operational readiness and incident response.

The partnership will provide a platform for NEA and DEMA to share and exchange knowledge and technical expertise in several areas -- environmental radiation monitoring, risk assessment of surface contamination, and public protection policies and measures.

Staff exchange visits and attachment programmes are also included in the partnership.

Director of NEA's Centre for Radiation Protection and Nuclear Science Mr Ang Kok Kiat and chief advisor of DEMA's Nuclear Division Mr Steen Cordt Hoe signed the LOI at the sidelines of the Fukushima Ministerial Conference on Nuclear Safety held in Koriyama City of Fukushima Prefecture, Japan.

The collaboration with DEMA was first mooted following a multi-agency delegation visit to Denmark led by NEA's chief executive officer, Mr Andrew Tan, in October 2011.

DEMA, a government agency under the Danish Ministry of Defence, is tasked with leading the Danish response to nuclear emergencies abroad for protection of the population and environment.

DEMA's nuclear emergency management capabilities include a nation-wide automatic monitoring system and forecasting of possible radioactive fallout on the basis of current weather data.

- CNA/lp



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Never compared Babri with terror acts: Rehman Malik

NEW DELHI: Pakistan interior minister Rehman Malik on Saturday denied he had equated the demolition of the Babri Masjid with terror attacks, and offered an assurance that he would get the death of Kargil martyr Captain Saurabh Kalia investigated.

Explaining comments he made after landing in New Delhi Friday evening, which were widely reported by the Indian media, Malik told NDTV news channel that he "had never compared" terror attacks with the Dec 6, 1992 mosque demolition.

"I am here with a message of love and peace, and both countries are working on a roadmap of peace and love, there is no option," the Pakistani interior minister told the news channel.

"When I spoke of Babri, I never compared it with terror acts," he said, adding: "What I said is that we do not want ugly incidents... Never made such a comparison," Malik said.

Malik had said Friday: "Terrorism brings grief, we do not want a 9/11, Bombay blast, Samjhauta Express blast, Babri Mosque demolition."

On his remarks on Kalia, Malik said: "My full sympathies are with the family... Since the matter concerns the ministry of defence, I will take the information and have it investigated... The cause of death is not yet determined. If he was tortured, how could you expect that we would give such a body (back), knowing the reaction it would elicit."

He also said that India had "never raised with Pakistan in any way" the issue of Kalia's death and it was not part of his agenda in India this time.

He accused the media of creating the agenda for the India-Pakistan talks, terming it "not fair".

Clarifying his remarks Friday on Kalia that were interpreted as dismissive, Malik said he had been "totally misquoted" and that he did not know "too much of the incident". "I am not a master computer," Malik said.

Capt Saurabh Kalia's mutilated and tortured body had been handed over to India after the 1999 Kargil conflict. Kalia's father has taken his son's torture-killing to the Supreme Court, saying Pakistan should be told to apologise. He has also approached the UN Human Rights Commission asking it to probe his son's death as a war crime.

Asked about it, Malik had said Friday: "When a fight is going on at the border, we really don't know whether he was killed with a Pakistani bullet or he died because of the weather."

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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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