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

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

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

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

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

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

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

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

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

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

BEWARE OF THE WITCH

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

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

RETHINKING APPLE

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

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

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

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

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

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

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Syrians Face a Bread Shortage in Aleppo and Elsewhere

Tyler Hicks/The New York Times

A bakery in Aleppo. The price has shot up from 15 Syrian pounds, about 21 cents, for a bag of about eight flat, pitalike loaves to more than 200 pounds, nearly $3.

GAZIANTEP, Turkey — Jalal al-Khanji, the closest thing the Syrian city of Aleppo has to a mayor, hopes to organize elections there within two weeks, but he fears that residents with empty stomachs are in no mood for an experiment in democracy.

Since late November, bread has been scarce, with a lack of fuel and flour shutting most bakeries in Aleppo.

“We cannot hold elections while people are hungry; we have to solve that problem first,” he said in an interview in this southern Turkish city, where many leaders of Aleppo’s civil society have sought refuge. “People are angry, frustrated and depressed. They can understand how countries like France and Britain and the United States might hold back on the issue of weapons, but not on the issue of bread and diesel.”

The revolution that erupted across Syria in March 2011 only slowly engulfed Aleppo, Syria’s commercial capital. Long after major cities were convulsed by demonstrations, Aleppo’s residents still showed up in Gaziantep by the busload every weekend to scour the malls.

The armed struggle for the city began in earnest last July.

In August, the prominent doctors, engineers, pharmacists and businessmen sheltering here established the Aleppo Transitional Revolutionary Council, a kind of city government in exile for the liberated portions of the city. Mr. Khanji, 67, a civil engineer with a long history of opposing the Syrian government, serves as its president.

Dividing their time between Gaziantep and Aleppo, council members found the chaos convulsing their city worrisome. What if all the competing militias on the ground, even if nominally part of the loosely allied Free Syrian Army, continued to fight for the spoils even after the government’s forces were driven from the city?

They decided the remedy was an elected council of about 250 members who would run both the city and the province of Aleppo, roughly one representative for every 20,000 people in the liberated areas. The council would choose a smaller group to actually govern the city.

The idea is for the council to serve as a liaison between the military and the civilian populations. “If civilian life is not organized, if we cannot do anything, then the chaos will continue,” said a 29-year-old businessman who is also on the transitional council. Several members of the council declined to give their names because they still travel to government-controlled areas.

About 65 percent of the villages have already chosen their representatives, he said, but the humanitarian crisis in Aleppo forced a postponement of the choice of about 150 representatives from the city itself.

The transitional council is in the process of establishing a 500-member police force and runs a few courts, but members view the bread crisis as their first big test. “We represent a civil government to some extent, so if we cannot solve this problem there will be a lack of trust in such rule in the future,” said the businessman.

There is also competition. While about 70 percent to 80 percent of the Free Syrian Army commanders in the province have agreed to support the elected council, election organizers said, opponents include jihadi groups hostile to the very idea of democratic elections.

One such prominent group, Jibhat al-Nusra, which the United States sought to ostracize last week by labeling it a terrorist organization, has been distributing bread in and around Aleppo.

“The so-called terrorists are the ones who have been giving us bread and distributing it fairly,” said Tamam Hazem, a spokesman in Aleppo’s news media center, reached via Skype. “Free Syrian Army battalions have been trying to help, but they just don’t have the same kind of experience.”

Council members pleaded for outside help to counter the jihadists’ efforts. “They are offering bread to people to obtain their sympathy and respect,” said Mr. Khanji, the council’s president. “Prolonging the Syrian crisis will allow the extremist cells in Syria to grow and become more difficult to remove in the future.”

Hania Mourtada contributed reporting from Beirut, Lebanon, and Sebnem Arsu from Kilis, Turkey.

This article has been revised to reflect the following correction:

Correction: December 16, 2012

A picture caption with an earlier version of this article misstated the prewar price of an eight-loaf bag of bread in Syria. It was 15 Syrian pounds, not 25. The article also misstated the United States dollar equivalent for that amount. It is 21 cents, not 35.

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Tumblr Users Flock to Mashable Comment Thread

Tumblr Is Down

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

Click here to view this gallery.

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

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

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

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

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

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

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

Image courtesy of Flickr, kurichan+

This story originally published on Mashable here.

Tech News Headlines – Yahoo! News

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Donald Faison Marries Cacee Cobb

By Lesley Messer

12/15/2012 at 08:25 PM EST

Cacee Cobb and Donald Faison

Dr. Billy Ingram/WireImage

It's official!

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

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

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

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

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

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

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

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Experts: No link between Asperger's, violence

NEW YORK (AP) — While an official has said that the 20-year-old gunman in the Connecticut school shooting had Asperger's syndrome, experts say there is no connection between the disorder and violence.

Asperger's is a mild form of autism often characterized by social awkwardness.

"There really is no clear association between Asperger's and violent behavior," said psychologist Elizabeth Laugeson, an assistant clinical professor at the University of California, Los Angeles.

Little is known about Adam Lanza, identified by police as the shooter in the Friday massacre at a Newtown, Conn., elementary school. He fatally shot his mother before going to the school and killing 20 young children, six adults and himself, authorities said.

A law enforcement official, speaking on condition of anonymity because the person was not authorized to discuss the unfolding investigation, said Lanza had been diagnosed with Asperger's.

High school classmates and others have described him as bright but painfully shy, anxious and a loner. Those kinds of symptoms are consistent with Asperger's, said psychologist Eric Butter of Nationwide Children's Hospital in Columbus, Ohio, who treats autism, including Asperger's, but has no knowledge of Lanza's case.

Research suggests people with autism do have a higher rate of aggressive behavior — outbursts, shoving or pushing or angry shouting — than the general population, he said.

"But we are not talking about the kind of planned and intentional type of violence we have seen at Newtown," he said in an email.

"These types of tragedies have occurred at the hands of individuals with many different types of personalities and psychological profiles," he added.

Autism is a developmental disorder that can range from mild to severe. Asperger's generally is thought of as a mild form. Both autism and Asperger's can be characterized by poor social skills, repetitive behavior or interests and problems communicating. Unlike classic autism, Asperger's does not typically involve delays in mental development or speech.

Experts say those with autism and related disorders are sometimes diagnosed with other mental health problems, such as depression, anxiety, bipolar disorder or obsessive-compulsive disorder.

"I think it's far more likely that what happened may have more to do with some other kind of mental health condition like depression or anxiety rather than Asperger's," Laugeson said.

She said those with Asperger's tend to focus on rules and be very law-abiding.

"There's something more to this," she said. "We just don't know what that is yet."

After much debate, the term Asperger's is being dropped from the diagnostic manual used by the nation's psychiatrists. In changes approved earlier this month, Asperger's will be incorporated under the umbrella term "autism spectrum disorder" for all the ranges of autism.

__

AP Writer Matt Apuzzo contributed to this report.

___

Online:

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

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

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

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

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

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

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

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

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

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

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

BEWARE OF THE WITCH

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

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

RETHINKING APPLE

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

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

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

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

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

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

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Panetta Orders Deployment of U.S. Antimissile Units in Turkey

Manu Brabo/Associated Press

In a part of Aleppo controlled by the Free Syrian Army, a woman hurt by Syrian Army shelling was wheeled in front of a hospital.

INCIRLIK AIR BASE, Turkey — Defense Secretary Leon E. Panetta signed an official deployment order on Friday to send 400 American military personnel and two Patriot air defense batteries to Turkey as its tensions intensify with neighboring Syria, where government forces have increasingly resorted to aerial attacks, including the use of ballistic missiles, to fight a spreading insurgency.

The American batteries will be part of a broader push to strengthen Turkey’s defenses that will include the deployment of four other Patriot batteries — two from Germany and two from the Netherlands. Each battery contains multiple rounds of guided missiles that can intercept and destroy other missiles and hostile aircraft flying at high speeds.

Mr. Panetta’s deployment order, the result of NATO discussions last week, represents the most direct American military action so far to help contain the Syrian conflict and minimize its risk of spilling across the 550-mile border with Turkey, a NATO member that is housing more than 100,000 Syrian refugees and providing aid to the Syrian rebels trying to oust President Bashar al-Assad.

Tensions between Turkey and Syria have escalated in recent months as Syrian forces have bombed rebel positions along the border and occasionally lobbed artillery rounds into Turkish territory. The Turks have also grown increasingly alarmed that Mr. Assad’s forces could fire missiles into Turkey.

News of the Patriot deployment order came as antigovernment activists inside Syria reported new mayhem, including an unconfirmed rebel claim to have shot down a government warplane attacking insurgent positions near the international airport in Damascus, the capital.

In Moscow, meanwhile, the Russian Foreign Ministry sought to distance itself from comments a day earlier by its Middle East envoy that the Syrian rebels might defeat Mr. Assad, a longstanding Kremlin ally and arms client. A ministry spokesman, Aleksandr K. Lukashevich, said Russia remained committed to a political solution in Syria.

“We have never changed our position and will not change it,” Mr. Lukashevich said. He rejected a comment made by a State Department spokesman on Thursday that Moscow had “woken up” and changed its position as dynamics shifted on the battlefield, saying, “We have never been asleep.”

All six Patriot units deployed in Turkey will be under NATO’s command and are scheduled to be operational by the end of January, according to officials in Washington.

George Little, the Pentagon spokesman, said Mr. Panetta signed the order as he flew from Afghanistan to this air base in southern Turkey, close to the Syrian border.

“The United States has been supporting Turkey in its efforts to defend itself,” Mr. Little said.

The order “will deploy some 400 U.S. personnel to Turkey to support two Patriot missile batteries,” Mr. Little added, and the personnel and Patriot batteries will arrive in Turkey in the coming weeks. He did not specify their deployment locations.

After landing at Incirlik on Friday, Mr. Panetta told a gathering of American Air Force personnel of his decision to deploy the Patriots.

He said the United States was working with Turkey, Jordan and Israel to monitor Syria’s stockpiles of chemical weapons, and warned of “serious consequences” if Syria used them, but he did not offer any specifics.

“We have drawn up plans for presenting to the president,” Mr. Panetta said. “We have to be ready.”

Turkey’s worries about vulnerability to Syrian missiles, including Scuds that might be tipped with chemical weapons, were heightened recently by intelligence reports that Syrian troops had mixed small amounts of precursor chemicals for sarin, a deadly nerve gas, at one or two storage sites, and loaded them into artillery shells and airplane bombs. “Their arsenal of chemical weapons has been configured for use at a moment’s notice,” Representative Mike Rogers, a Michigan Republican who heads the House Intelligence Committee, said in an interview on Friday. Mr. Panetta, however, said this week that intelligence about chemical weapons activity in Syria had “leveled off.”

Recent Scud missile attacks by Mr. Assad’s forces against rebels in northern Syria have only added to Turkey’s concerns. The Scud missiles were armed with conventional warheads, but the attacks showed that the Assad government was prepared to use missiles as it struggled to slow rebel gains.

With the nearly two-year-old Syrian conflict entering its second winter and many thousands of people struggling for food and warmth in cities ruined by protracted fighting, the humanitarian costs seemed to be mounting.

An activist in the central province Homs, who identified himself as Abu Ourouba, said the town of Houla — where, the United Nations confirmed in May, Syrian troops had killed more than 100 people, including 32 children — was facing catastrophe.

“Houla has been besieged from all directions for the past 10 days,” he said. “Until now, not even one loaf of bread has entered Houla. The food that was available is beginning to run out very quickly. Most children don’t have milk anymore. The kids are at risk of dying from hunger.”

Shelling along access routes means that no one can walk “unless they crawl” to avoid hundreds of strikes from tanks, warplanes and rocket launchers, the activist said.

Thom Shanker reported from Incirlik Air Base, Turkey, and Michael R. Gordon from Washington. Reporting was contributed by Eric Schmitt from Washington; Anne Barnard, Hania Mourtada and Hwaida Saad from Beirut, Lebanon; Alan Cowell from London; and Ellen Barry from Moscow.

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5 YouTube Videos to Help Winterize Your Home

1. Caulk Talk

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

Click here to view this gallery.

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

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

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

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

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

Any big tips we missed? Let us know below.

Image courtesy of Flickr, Jason Persse

This story originally published on Mashable here.

Tech News Headlines – Yahoo! News

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Gunman's Father and Brother Are 'in Shock,' Says a Source

By Diane Herbst

12/14/2012 at 08:50 PM EST

State police personnel lead children to safety away from the Sandy Hook Elementary School

Shannon Hicks/Newtown Bee/Reuters/Landov

The father and older brother of the gunman who was blamed for the Connecticut school shooting are being questioned by authorities but are not suspects, a law enforcement source tells PEOPLE.

The Associated Press reports that the gunman has been identified as 20-year-old Adam Lanza.

His unidentified father, who lives in New York City, and his older brother, Ryan, 24, of Hoboken, N.J., are "in shock," the law enforcement source tells PEOPLE.

They were being questioned by the FBI in the Hoboken police station but "are not suspects, they have no involvement," the source says.

"Imagine the 24 year old – he's lost his mother. Imagine the father, his son killed 20 kids," the source says."   

As for Adam, "It looks like there's mental history there," the law enforcement source says.

Adam Lanza died at the scene of the shooting that killed 20 children and six adults at the Sandy Hook Elementary School in Newtown, Conn.

His mother, Nancy Lanza, was found dead at her home, according to CNN.

The source describes the weapons used by Lanza as "legitimate." According to CNN, Lanza used two hand guns that were registered to his mother and a rifle.

Adam's parents were no longer together, the source says.   

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Fewer health care options for illegal immigrants

ALAMO, Texas (AP) — For years, Sonia Limas would drag her daughters to the emergency room whenever they fell sick. As an illegal immigrant, she had no health insurance, and the only place she knew to seek treatment was the hospital — the most expensive setting for those covering the cost.

The family's options improved somewhat a decade ago with the expansion of community health clinics, which offered free or low-cost care with help from the federal government. But President Barack Obama's health care overhaul threatens to roll back some of those services if clinics and hospitals are overwhelmed with newly insured patients and can't afford to care for as many poor families.

To be clear, Obama's law was never intended to help Limas and an estimated 11 million illegal immigrants like her. Instead, it envisions that 32 million uninsured Americans will get access to coverage by 2019. Because that should mean fewer uninsured patients showing up at hospitals, the Obama program slashed the federal reimbursement for uncompensated care.

But in states with large illegal immigrant populations, the math may not work, especially if lawmakers don't expand Medicaid, the joint state-federal health program for the poor and disabled.

When the reform has been fully implemented, illegal immigrants will make up the nation's second-largest population of uninsured, or about 25 percent. The only larger group will be people who qualify for insurance but fail to enroll, according to a 2012 study by the Washington-based Urban Institute.

And since about two-thirds of illegal immigrants live in just eight states, those areas will have a disproportionate share of the uninsured to care for.

In communities "where the number of undocumented immigrants is greatest, the strain has reached the breaking point," Rich Umbdenstock, president of the American Hospital Association, wrote last year in a letter to Obama, asking him to keep in mind the uncompensated care hospitals gave to that group. "In response, many hospitals have had to curtail services, delay implementing services, or close beds."

The federal government has offered to expand Medicaid, but states must decide whether to take the deal. And in some of those eight states — including Texas, Florida and New Jersey — hospitals are scrambling to determine whether they will still have enough money to treat the remaining uninsured.

Without a Medicaid expansion, the influx of new patients and the looming cuts in federal funding could inflict "a double whammy" in Texas, said David Lopez, CEO of the Harris Health System in Houston, which spends 10 to 15 percent of its $1.2 billion annual budget to care for illegal immigrants.

Realistically, taxpayers are already paying for some of the treatment provided to illegal immigrants because hospitals are required by law to stabilize and treat any patients that arrive in an emergency room, regardless of their ability to pay. The money to cover the costs typically comes from federal, state and local taxes.

A solid accounting of money spent treating illegal immigrants is elusive because most hospitals do not ask for immigration status. But some states have tried.

California, which is home to the nation's largest population of illegal immigrants, spent an estimated $1.2 billion last year through Medicaid to care for 822,500 illegal immigrants.

The New Jersey Hospital Association in 2010 estimated that it cost between $600 million and $650 million annually to treat 550,000 illegal immigrants.

And in Texas, a 2010 analysis by the Health and Human Services Commission found that the agency had provided $96 million in benefits to illegal immigrants, up from $81 million two years earlier. The state's public hospital districts spent an additional $717 million in uncompensated care to treat that population.

If large states such as Florida and Texas make good on their intention to forgo federal money to expand Medicaid, the decision "basically eviscerates" the effects of the health care overhaul in those areas because of "who lives there and what they're eligible for," said Lisa Clemans-Cope, a senior researcher at the Urban Institute.

Seeking to curb expenses, hospitals might change what qualifies as an emergency or cap the number of uninsured patients they treat. And although it's believed states with the most illegal immigrants will face a smaller cut, they will still lose money.

The potential impacts of reform are a hot topic at MD Anderson Cancer Center in Houston. In addition to offering its own charity care, some MD Anderson oncologists volunteer at a county-funded clinic at Lyndon B. Johnson General Hospital that largely treats the uninsured.

"In a sense we've been in the worst-case scenario in Texas for a long time," said Lewis Foxhall, MD Anderson's vice president of health policy in Houston. "The large number of uninsured and the large low-income population creates a very difficult problem for us."

Community clinics are a key part of the reform plan and were supposed to take up some of the slack for hospitals. Clinics received $11 billion in new funding over five years so they could expand to help care for a swell of newly insured who might otherwise overwhelm doctors' offices. But in the first year, $600 million was cut from the centers' usual allocation, leaving many to use the money to fill gaps rather than expand.

There is concern that clinics could themselves be inundated with newly insured patients, forcing many illegal immigrants back to emergency rooms.

Limas, 44, moved to the border town of Alamo 13 years ago with her husband and three daughters. Now single, she supports the family by teaching a citizenship class in Spanish at the local community center and selling cookies and cakes she whips up in her trailer. Soon, she hopes to seek a work permit of her own.

For now, the clinic helps with basic health care needs. If necessary, Limas will return to the emergency room, where the attendants help her fill out paperwork to ensure the government covers the bills she cannot afford.

"They always attended to me," she said, "even though it's slow."

___

Sherman can be followed on Twitter at https://twitter.com/chrisshermanAP .

Plushnick-Masti can be followed on Twitter at https://twitter.com/RamitMastiAP .

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