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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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. Most of the city’s bakeries are shut down because of shortages.







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 efforts of the jihadists. “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.



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App of the Week: Manilla






App Name: Manilla


Price: Free






Available Platforms: Apple’s iOS ( iPad, iPod Touch and iPhone), Android


What does this app do? Manilla provides a secure way for you manage and organize your bills on your mobile device, tablet or desktop. This finance app, of which an updated version for the iPhone 5 was released this week, allows you to link to your accounts, set up reminders to pay your bills, and keep track of household finances such as utilities and services.


From your mobile device, select the “Accounts” tab to see a queue of accounts you linked to within the app. On the bottom right, tap the settings button to add an account.The new release also lets you manage your accounts with local businesses or individuals who do not have an online payment system – the landscaper or babysitter, for example.


Press the “Reminders” tab to select a business you use, such as your wireless carrier. The app will display a screen with your account and bill information as well as let you set up reminders to pay your bill, which will be delivered through email or text message. Select, “View Bill,” to see details, such as when you made your last payment, or select “Documents” and the app’s built in PDF viewer will display your bill within the application.


You cannot pay your bill directly from the app. However, select “Go to Site” and the app will direct you to a business’s website where you can pay your bill.


Is it easy to set up? Yes. Once you download Manilla, the app requires you to register with an email and password.


Should I try it? Manilla takes all of your bill information and puts into an easy-to-use interface, and with over 3,500 businesses the app makes it easy to link to a variety of accounts. If you’re interested in building and monitoring a budget, too, you will find a better solution with Mint.com’s app. Still, Manilla makes keeping track of all of your bills simple – a sure way to stay on top of your finances.


Also Read
Wireless News Headlines – Yahoo! News


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Reese Witherspoon Spreads Holiday Cheer While Stuck in Traffic















12/14/2012 at 12:00 PM EST







Reese Witherspoon in Brentwood, Calif.


Splash News Online; Inset: FilmMagic


Reese Witherspoon beat the gridlock gloom with a pinch of holiday humor on Thursday.

The actress was spotted driving a car that would make her the envy of any Christmas fanatic. Witherspoon tricked out her Land Rover with reindeer antlers flanking each side and a red Rudolph nose on the front.

The silly decorations might not illicit giggles from baby Tennessee just yet, but Witherspoon's cute car surely cheered up other drivers lucky enough to catch a glimpse.

The actress, 36, recently joked that she's working on getting her pre-baby brain back. "I couldn't remember, the other day, what you call that thing that keeps the food cold. It was the refrigerator," said Witherspoon. "I couldn't remember the name of it!"

Julia Haskins

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APNewsBreak: Texas cancer probe draws NCI scrutiny


AUSTIN, Texas (AP) — The federal National Cancer Institute says it's taking a fresh look at a troubled $3 billion cancer-fighting effort already being scrutinized by prosecutors and lawmakers in Texas.


The U.S. government's cancer research agency confirmed Friday that upheaval within the Cancer Prevention and Research Institute of Texas caught its attention. NCI spokeswoman Aleea Farrakh Khan told The Associated Press that officials are "evaluating recent events" at CPRIT.


CPRIT is on an exclusive list of NCI-approved funding entities, which includes the American Cancer Society. The designation is a federal seal-of-approval that signals high peer review standards and conflict of interest policies.


Khan says NCI has made no decisions about CPRIT or contacted the agency directly.


Prosecutors are investigating CPRIT following an $11 million award to a private company that bypassed review.


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Wall Street drops as Apple falls, "cliff" looms

NEW YORK (Reuters) - Stocks fell on Friday, with the Nasdaq weighed down by another drop in shares of Apple, and as the overhang of "fiscal cliff" negotiations kept buying to a premium.


Apple slid 4 percent to $508.75 after UBS cut its price target on the stock to $700 from $780. The most valuable U.S. company has seen its stock hit hard in the last three months, and it fell on Friday after a tepid reception for iPhone 5 in China.


The S&P Information Technology Index <.gspt> dropped 0.9 percent as Apple fell and Jabil Circuit Inc lost 6.2 percent to $17.38 after UBS cut its price target.


The possibility of a "fiscal cliff" deal not taking place until early 2013 is rising. The back-and-forth negotiations over the fiscal cliff in Washington have kept markets on hold in what would already be a quiet period for stocks.


"We're faced with uncertainty ... and that's going to continue now into January. It basically puts everybody on hold, and (you) just have the markets kind of thrash around," said Larry Abruzzi, senior equity trader at Cabrera Capital Markets Inc in Boston.


President Barack Obama and House of Representatives Speaker John Boehner held a "frank" meeting on Thursday at the White House to discuss how to avoid the tax hikes and spending cuts set to kick in early in 2013.


The S&P 500 dropped 0.6 percent on Thursday after six straight positive sessions. Investors are concerned that going over the cliff could tip the economy back into recession. While a deal is expected to ultimately be reached, a drawn-out debate - like the one seen over 2011's debt ceiling - can erode confidence.


"The markets are not being reactionary right now, though we lost ground yesterday," said Stephen Carl, head equity trader at the Williams Capital Group in New York.


"It doesn't look like anything has been resolved, or is leaning one way or another."


Still, expectations of an eventual agreement have helped the S&P 500 bounce back over the last month, and on Wednesday, the index hit its highest intraday level since late October. For the year, the S&P has advanced more than 12 percent.


The Dow Jones industrial average <.dji> slipped 24.09 points, or 0.18 percent, to 13,146.63. The Standard & Poor's 500 Index <.spx> lost 4.81 points, or 0.34 percent, to 1,414.64. The Nasdaq Composite Index <.ixic> fell 15.50 points, or 0.52 percent, to 2,976.66.


Best Buy Co Inc slid 15.5 percent to $11.93 after the electronics retailer agreed to extend the deadline for the company's founder to make a bid. Shares jumped as much as 19 percent on Thursday after initial reports of a bid this week from founder Richard Schulze.


Consumer prices fell in November for the first time in six months, indicating U.S. inflation pressures were muted. A separate report showed manufacturing grew at its swiftest pace in eight months in December.


Data out of China was encouraging, as Chinese manufacturing grew at its fastest pace in 14 months in December. The news was seen as helping U.S. materials companies, including U.S. Steel , which rose 6.3 percent to $23.73.


(Editing by Bernadette Baum and Jan Paschal)



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The Lede Blog: Journalists Punched by Israeli Officers After Fatal Shooting at West Bank Checkpoint

Two Palestinian journalists working for Reuters were punched, hit with rifle butts and forced to strip by Israeli soldiers on Wednesday as they tried to reach the scene of a fatal shooting at a West Bank checkpoint, the news agency reports. The soldiers then confiscated the crew’s camera and gas masks before letting off a tear-gas canister which forced one of the men to seek medical treatment.

Although the journalists had press credentials, they were not allowed to show them by the officers, who accused them of working instead for an Israeli human rights group, B’Tselem, which provides video cameras to Palestinians to help document life under Israeli military occupation.

Someone who was does work with the Israeli rights group managed to record video at the checkpoint in the city of Hebron, just after the fatal shooting of Muhammad al-Salameh, 17.

Video recorded on Wednesday in the West Bank city of Hebron by a volunteer for an Israeli human rights group, just after a Palestinian was shot and killed by an Israeli officer.

The video includes a brief glimpse of the boy lying on the ground and, according to Ali Abunimah, the Palestinian-American founder of The Electronic Intifada, near the end of the clip, “medics can be seen attending to Muhammad as a voice calls for his father, ‘Abu Awad.’ In the final moments of the video a man, possibly Abu Awad, is heard saying, ‘Ibni, ibni’ – ‘My son, my son.’”

As the Israeli newspaper Haaretz reported, the officer who shot the boy said that she fired only after the boy attacked another officer and pulled out a toy gun that looked real. A spokesman for the Israel Defense Forces, Captain Barak Raz, posted an image on Twitter of what he said was the toy gun in the boy’s possession on Twitter.

The dead boy’s uncle told Agence France-Presse, “The plastic gun story isn’t true and it is all fabrication,” adding that Muhammad was stopped by the officers on his way to a bakery to pick up a cake for his 17th birthday party. A photograph said to show Muhammad hours before he was shot and killed, grinning during a birthday celebration at school, circulated online after his death.

According to a report on the Israeli news blog +972, the dead boy’s family said that “none of those who knew Muhammad had ever seen” the toy gun in his possession. The blogger added that while the two versions of events do not match, “Luckily, the checkpoints in Hebron are monitored by Israeli security cameras, and I am sure that if her story is true, the I.D.F. will release the video, showing a 17-year-old teen taking out a toy gun and holding it to the head of a soldier.”

The young female officer who fired the fatal shots, described in Israeli media reports as a 19-year-old, told The Jerusalem Post, “I know I did the right thing. This is what they taught us, to fire at the terrorist in order to neutralize them, fake gun or not.”

The Israeli security forces in Hebron are there in large numbers to protect several hundred Jewish settlers who moved to the city of nearly 200,000 Palestinians after it was occupied by Israel’s military in 1967. The shooting took place near the boy’s home and the Tomb of the Patriarchs, a site revered by Jews and Muslims as the traditional burial place of the founding fathers of both religions.

The Foreign Press Association in Israel said in a statement describing the incident that it “condemns in the strongest terms the assault by Israeli soldiers of two of our members in Hebron.” The statement continued:

Yousri Al Jamal and Ma’amoun Wazwaz, both highly experienced cameramen who work for Reuters, were stopped while driving to the scene of a shooting incident in the heart of the city. Their car was clearly marked ‘TV’ and they were both wearing blue flak jackets with ‘Press’ emblazoned on the front. The soldiers forced them to leave the vehicle at gunpoint, punching them and hitting them with the butts of their guns. The two men were not allowed to show their ID and were made to strip and kneel in the street with their hands behind their head. One of the soldiers then dropped a tear-gas canister in front of the men and the IDF patrol ran away. More tear gas was fired as Jamal and Wazwaz tried to escape the scene. Wazwaz was overwhelmed by the fumes and needed hospital treatment.

The group also welcomed Israel’s promise to investigate the incident, but added that it is still waiting to hear the results of the Israeli military’s investigation into an attack on a journalist in another part of the West Bank four months ago.

Paul Danahar, the group’s chairman and the BBC’s Middle East bureau chief, was distinctly downbeat about the possibility of the military’s investigation in a message posted on Twitter shortly before the statement was released.

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Apple falls on lower shipment forecasts, muted China debut






(Reuters) – Apple Inc shares fell 3.9 percent on Friday after the iPhone 5 debuted in China to a cool reception and two analysts cut shipment forecasts.


Jefferies analyst Peter Misek trimmed his iPhone shipment estimates for the Jan-March quarter, saying that the technology company had started cutting orders to suppliers to balance excess inventory.






Shares of Apple suppliers Jabil Circuit Inc, Qualcomm Inc, Skyworks Solutions Inc, TriQuint Semiconductor Inc, Avago Technologies Ltd, and Cirrus Logic Inc also fell in early trading.


Apple shares have lost a quarter of their value since they hit a life high of $ 705.07 on September 21, as it faces increasing competition from phones using Google Inc’s Android operating system.


Misek cut his first-quarter iPhone sales estimate to 48 million from 52 million and gross margin expectations for the company by 2 percentage points to 40 percent.


UBS Investment Research cut its price target on Apple stock to $ 700 from $ 780 on lower expected iPhone and iPad shipments for the March quarter.


The brokerage said it was modeling more conservative growth for the world’s biggest technology company after making supply chain checks that revealed that fewer iPhones were being built.


“Some of our Chinese sources do not expect the iPhone 5 to do as well as the iPhone 4S,” UBS analyst Steven Milunovich wrote in a note to clients.


Apple launched the iPhone 5 in China on Friday, a move widely expected to bring the Cupertino-based company some respite from a recent slide in market share in China, but early reports indicated that demand may not be as great as expected.


“The iPhone 5 China launch has been surprisingly muted but (we) are unsure how much weather (snow) or the required pre-ordering (to prevent riots) are factors,” Misek said.


Apple shares fell as low as $ 508.50 in morning trading on the Nasdaq on Friday.


(Editing by Supriya Kurane)


Tech News Headlines – Yahoo! News


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Lindsey Vonn Reveals Depression Battle






Photo Exclusive








12/13/2012 at 12:45 PM EST



Lindsey Vonn seems to have it all.

As the most decorated skier in U.S. history, Vonn's easy smile and record-decimating athletic career have made her a fixture on podiums, magazine covers and multi-million dollar endorsement deals. But life off the slopes wasn't always so rosy.

In an exclusive interview with PEOPLE, the Olympic gold medalist, 28, discloses that she's quietly suffered from depression for many years and currently takes an anti-depressant to help manage her symptoms.

"Everything about my life seemed so perfect to people. But I struggle like everyone else," Vonn confesses.

At one point in 2008, she says, "I couldn't get out of bed anymore. I felt hopeless, empty, like a zombie."

But these days, Vonn is happier than she's been in a long time. "I feel like I just needed to get everything off my chest," says the ski racer, who filed for divorce late last year from her husband Thomas Vonn, also her longtime manager and coach.

With the winter race season underway – Vonn nabbed her 57th World Cup win on Dec. 8 in St. Moritz, Switzerland – she's hit a new groove.

"All the parts of my life are finally in sync," she says. "I accept who I am, and I'm moving forward."

For the star athlete's exclusive interview and photo shoot, pick up PEOPLE magazine, on newsstands Friday

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