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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N Korea marks first anniversary of late ruler's death

SEOUL: North Korean leader Kim Jong-Un led thousands of officials on Sunday in a memorial ceremony for his late father and ex-ruler Kim Jong-Il, days after a successful long-range rocket launch.

The ceremony followed a mass rally two days earlier hailing the launch of the three-stage rocket, a move which was condemned by the UN Security Council and seen by many countries as a disguised ballistic missile test.

Kim Jong-Il, who ruled the communist state for 17 years, died of a heart attack on December 17 last year.

His youngest son Jong-Un immediately took over, the second dynastic succession by the Kim dynasty which has ruled the isolated country for more than six decades with an iron fist and a pervasive personality cult.

Officials in black suits and uniformed military leaders convened in a cavernous stadium in the capital Pyongyang Sunday morning for the hour-long memorial event, which was televised live on state TV.

Jong-Un, stone-faced and clad in a black suit, sat on stage with dozens of other top officials against the backdrop of a giant red flag featuring a large portrait of a smiling Kim Jong-Il.

"The heart of the great leader stopped beating but Comrade Kim Jong-Il lives with us forever... to give blessings for the bright future of our people," the ceremonial head of state Kim Yong-Nam said in a speech.

"The successful launch of our Kwangmyongsong-2 satellite is also another victory achieved by our military and people, by faithfully following the teachings of the great leader (Kim Jong-Il)," he said.

It was unclear what memorial events were scheduled on Monday, the anniversary day.

The North said the apparently successful launch -- its second after a much-heralded but botched mission in April -- was a scientific project to put a weather satellite into orbit.

But the United States and other nations viewed it as a disguised ballistic missile test banned under UN resolutions triggered by its past nuclear tests in 2006 and 2009.

The Security Council Wednesday condemned the launch and said members "will continue consultations on an appropriate response".

The impoverished but nuclear-armed nation apparently timed the launch to mark the death anniversary and to drum up more support for the young and inexperienced Jong-Un.

Choe Ryong-Hae, the head of the political bureau at the North's military, vowed to "hit back immediately" if rival South Korea or the United States provokes the nation, and reaffirmed loyalty to the young leader.

"Our whole army stands ready for battle under the teachings of Kim Jong-Un while the US and South's enemy forces are going amok to destroy our system," he said in a speech.

"It is our firm determination to hit back immediately at provocations...and we solemnly pledge again to faithfully serve our dear supreme commander (Jong-Un)," Choe said to big applause from the crowd.

Mass rallies are being staged nationwide to celebrate the rocket launch, the ruling party newspaper Rodong Sinmun said on Sunday.

Officials, students, workers and soldiers in three northern provinces rallied Saturday to give speeches and sing songs in memory of the late ruler and to praise his son for leading the successful launch, it said.

- AFP/xq

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India pursuing Capt Kalia's case with Pakistan: Antony

NEW DELHI: India is pursuing with Pakistan the case of Captain Saurabh Kalia, who was tortured and killed by Pakistani troops after being captured in the Kargil sector in May 1999, defence minister, AK Antony, said today.

"We are handling it in an appropriate manner. We will pursue it and now we are pursuing it with Pakistan," he told reporters here after laying a wreath at the Amar Jawan Jyoti to commemorate the 41st anniversary of the Indian victory in the 1971 war with Pakistan.

The minister was asked if India was pushing for a probe by Pakistan into the death of Captain Kalia.

Captain Kalia's father, NK Kalia, has taken up the case with the United Nations Human Rights Commission for a direction to Pakistan to probe the death of his son.

He has also filed a plea in the Supreme Court to direct the government to take up the case of his son's torture at the International Court of Justice (ICJ) at the Hague. The Supreme Court had on Friday sought response from the Centre on NK Kalia's plea.

However, India is not in favour of taking the matter to ICJ as it feels that it was a bilateral issue and it has always maintained that there should be "non-interference" by ICJ in "bilateral or internal" matters.

"And this(Kalia issue) is obviously a bilateral matter between India and Pakistan and, therefore, the position we have taken in ICJ for a very, very good reason," external affairs minister, Salman Khurshid, has said.

He stressed that India should not give up that position "lightly" as "it will cost us a great deal".

In May 1999, Captain Kalia had gone out for patrol duty in Kaksar area of Kargil along with five other soldiers— Sepoys Arjunram Baswana, Mula Ram Bidiasar, Naresh Singh Sinsinwar, Bhanwar Lal Bagaria and Bhika Ram Mudh.

They were caught by the Pakistan Army, which kept them in captivity for over 22 days and subjected them to brutal torture which was evident from their bodies that were handed over by the Pakistan Army to India on June 9, 1999.

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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

(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.

      (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.

(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.”

(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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Philippine police shoot dead Malaysian carrying bomb

MANILA: A man with alleged ties to Islamic militants was shot dead in the Philippines after he threatened to set off a backpack bomb in a stand-off with local police, an official said Saturday.

A suspect identified by police as Mohammad Noor Fikrie of Malaysia was killed in the southern city of Davao after he threatened to blow up an explosive device in a rucksack, city police chief Ronald de la Rosa said.

"'If you arrest or shoot me I have a bomb. I will explode it,'" de la Rosa quoted the suspect as telling police at the lobby of a hotel during a three-and-a-half-hour stand-off.

The authorities had raided the hotel after a tip-off that one of its guests was planning a "terror" attack in the city of 1.4 million people, de la Rosa said, without elaborating on the source of the information.

He said the Malaysian was a suspected member of Jemaah Islamiyah, an Islamic militant group blamed for attacks in Southeast Asia including the Bali bombing in Indonesia in 2002 that claimed 202 lives.

"Take-down orders were given to SWAT snipers but (it) could not be implemented since the area was overcrowded," de la Rosa told reporters by telephone.

While in the hotel lobby the suspect brandished a mobile phone, which, he said was the trigger for the explosives contained in the backpack that was being carried by his Filipina wife, de la Rosa said.

The man later took the rucksack from the woman and ran out of the hotel and into a nearby park, where he was shot and killed by police snipers, the police official added.

De la Rosa said police arrested the woman, Anabelle Nieva Lee, and disarmed an "improvised explosive device" that included a mortar shell retrieved from the backpack.

The authorities are investigating the woman's possible involvement with Jemaah Islamiyah, de la Rosa said, adding police believe she had converted to Islam when she married the Malaysian.

Philippine authorities said a small number of Jemaah Islamiyah militants have taken refuge with Filipino Muslim militants operating on the southern island of Mindanao.

- AFP/ck

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Kashmir valley remains cut-off from country for second day

SRINAGAR: The Kashmir valley remained cut-off from rest of the country for the second consecutive day today, but improvement in weather has raised hopes of early restoration of traffic on the Srinagar-Jammu national highway.

"The National Highway is still closed but work is going on to clear the road of the snow at the earliest," Aamir Ali, coordinator of Natural Disaster Management Cell, told PTI.

The 294-km arterial highway, the only all weather road link between the Valley and rest of the country, was closed yesterday following heavy snowfall on either side of the Pir Panjal range in south Kashmir.

"The weather has improved and we are hopeful that the road will be restored for clearing the stranded vehicles very soon," Ali said.

Meanwhile, there was a slight improvement in the night temperature across Kashmir division with Srinagar city, the summer capital of Jammu and Kashmir, recording a minimum of 1.4 deg C, a spokesman of the MeT office said.

Gulmarg ski resort in north Kashmir's Baramulla district was the coldest place in the Valley, recording a minimum of minus 4.7 deg C, the spokesman said.

He said Leh was the coldest place in the Kashmir division where mercury dipped to minus 10 deg C last night while nearby Kargil district recorded a low of minus 6.2 degree celsius.

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Fewer health care options for illegal immigrants

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Conn. Shooter Adam Lanza: 'Obviously Not Well'

Adam Lanza of Newtown, Connecticut was a child of the suburbs and a child of divorce who at age 20 still lived with his mother.

This morning he appears to have started his day by shooting his mother Nancy in the face, and then drove her car to nearby Sandy Hook Elementary School, armed with two handguns and a semi-automatic rifle.

There, before turning his gun on himself, he shot and killed 20 children, who President Obama later described as "beautiful little kids" between five and 10 years of age. Six adults were also killed at the school. Nancy Lanza was found dead in her home.

A relative told ABC News that Adam was "obviously not well."

Family friends in Newtown also described the young man as troubled and described Nancy as rigid. "[Adam] was not connected with the other kids," said Barbara Frey, who also said he was "a little bit different ... Kind of repressed."

State and federal authorities believe his mother may have once worked at the elementary school where Adam went on his deadly rampage, although she was not a teacher, according to relatives, perhaps a volunteer.

Nancy and her husband Peter, Adam's father, divorced in 2009. When they first filed for divorce in 2008, a judge ordered that they participate in a "parenting education program."

Peter Lanza, who drove to northern New Jersey to talk to police and the FBI, is a vice president at GE Capital and had been a partner at global accounting giant Ernst & Young.

Adam's older brother Ryan Lanza, 24, has worked at Ernst & Young for four years, apparently following in his father's footsteps and carving out a solid niche in the tax practice. He too was interviewed by the FBI. Neither he nor his father is under any suspicion.

Tragedy at the Elementary School: What Happened in Newtown, Conn. Watch Video

Newtown, Connecticut Shooting: 27 Killed, Gunman Dead Watch Video

"[Ryan] is a tax guy and he is clean as a whistle," a source familiar with his work said.

Police had initially identified Ryan as the killer. Ryan sent out a series of Facebook posts saying it wasn't him and that he was at work all day. Video records as well as card swipes at Ernst & Young verified his statement that he had been at the office.

Two federal sources told ABC News that identification belonging to Ryan Lanza was found at the scene of the mass shooting. They say that identification may have led to the confusion by authorities during the first hours after the shooting. Neither Adam nor Ryan has any known criminal history.

A Sig Sauer handgun and a Glock handgun were used in the slaying and .223 shell casings – a round used in a semi-automatic military-style rifle -- were also found at the scene. Nancy Lanza had numerous weapons registered to her, including a Glock and a Sig Sauer. She also owned a Bushmaster rifle -- a semi-automatic carbine chambered for a .223 caliber round. However, federal authorities cannot confirm that the handguns or the rifle were the weapons recovered at the school.

Numerous relatives of the Lanzas in New Jersey, Connecticut, Massachusetts, as well as multiple friends, are being interviewed by the FBI in an effort to put together a better picture of the gunman and any explanation for today's tragedy.

"I think the most important thing to point out with this kind of individual is that he did not snap this morning and decide to act out violently," said former FBI profiler Mary Ellen O'Toole. "These acts involve planning and thoughtfulness and strategizing in order to put the plan together so what may appear to be snap behavior is not that at all."

With reporting by Pierre Thomas, Jim Avila, Santina Leuci, Aaron Katersky, Matthew Mosk, Jason Ryan and Jay Shaylor

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