Art for Wealth’s Sake: Art Basel Paints a Picture of Miami’s Separate and Unequal Worlds

It’s 10 p.m. on a Friday night. A naked girl is splashing about in the swimming pool at the Standard Hotel Miami. She is from New York and runs a nonprofit for homeless teens. We’ll call her Liz: “You’re so boring!” she yells from the middle of the pool.

It was a common refrain here during Art Basel Miami Beach—now the world’s largest contemporary art fair—where many of earth’s most privileged humans gather for a week of champagne and gawking at art (and at each other) in the sun.

The poolside celebration was for Terry Richardson, a fashion photographer known for his sexually charged (or sexually abusive, depending on your source) shoots. A cell phone company, HTC, spent $ 100,000 to sponsor the party, a book release for Richardson. This is a typical event, one of hundreds that occur during what is commonly referred to as “Basel.”

MORE: Scenes From a Class War (VIDEOS)

Basel is now 11 years old. It’s gone from a decent sized art fair to an international marketing and branding orgy with few parallels. Because all the big collectors fly down private, and scores of cool young New Yorkers file in on JetBlue, luxury brands rush in to hit both their “target demos” and “tastemakers” in one shot.

In terms of tourism dollars, Basel is Miami’s highest grossing week. Hotels on South Beach were demanding thousands per night for rooms. The fair’s main sponsor was the honorable UBS, the very same Swiss bank that just settled a billion dollar fraud case with international authorities. UBS not only robs the world and stashes terrorist/dictator cash, it sponsors art fairs too—cool guys.

Most Miamians don’t care about Art Basel. The city is only 11 percent white (far and away the primary Basel target demographic), and most of the 40 percent Hispanic and 20 percent black populations live far from the South Beach glam, many in poverty. Miami has the second widest gap between rich and poor in America, after New York. Blacks make an average of $ 15,000 a year. Whites double that, at $ 37,000. But at $ 19,000, the city’s majority Hispanics aren’t doing so well either.

Disparity defines the art world too, with its hungry artists and rich collectors and patrons. So it’s fitting that the largest contemporary art fair in the world happens in Miami.

Few people are more detached from the short-end reality of income disparity than the global art tribe. These arbiters of the cultural elite fly around the world to various openings and fairs then retreat to galleries, museums and studios in their home cities before heading out again. Of course, there are exceptions. Some artists at Basel retain a socio-politico aesthetic. A good example is Barbara Krueger, whose text-orientated pieces mocking consumerism and political power were selling for $ 200,000 to $ 500,000 and became the talk of the fair.

Bearing many hallmarks of a third world city, Miami breaks down into two distinct populations. The rich live across Biscayne Bay on beautiful beaches and gated islands. The poor are stretched across downtown’s grid, where every block headed west from the bay is worse than the one before it. The city has few economically diverse neighborhoods.

The two Miamis can easily be visited on the same day. Last week. Alex “A-Rod” Rodriguez, the New York Yankee third baseman with the largest sports contract in history, was having a party in his $ 30 million modernist manse.

I skipped A Rod’s soiree, mainly because I hate the Yankees, to hang out with Dee, a 22-year-old drug dealer who lives on west 20th Street downtown. All he wanted was customers: “Man, who down here needs anything? I’m fucking broke. I live in the projects with my aunt. Gotta get out.”

Dee said he’d take any job—as in, “I’ll work at Chick-fil-A, man!” Saddled with a criminal record, he’s never been hired anywhere.

We cruised over to 75th Street, the main drag in Little Haiti, where public housing is painted lime green and similarly awesome pastel paint jobs cover buildings advertising W.I.C and Western Union.

“There are no banks here,” Dee tells me. “We don’t have enough money.”

UBS—where are you?

The South Beach Basel crowd hosted quite a few Hurricane Sandy benefits. But I didn’t find one art world benefit for Miami’s poor. There is a definite willful ignorance in plopping your billionaires down at dinners and six-figure parties in the name of “culture” while ignoring masses of people who are in dire need of said culture and are readily at hand: The impoverished residents of Miami.

Back in New York, I catch up with Liz, the naked pool gal. She’s in Tompkins Square Park, the epicenter of Manhattan’s Lower East Side. Stella is smiling. Her art world disdain has clearly dried off.

“I have no idea why I was in Miami,” she says. “Who were those people? Why are they so boring, and why did that one guy in the black suit keep saying Le Baron over and over again?”

Around the same time I get a text from Dee. “You know anyone still down here? Tryna get that $ .”

I inform Lee that Le Baron is a Parisian disco that does a chic party every night of Basel.

Lee receives this information as she’s handing out clean needles and Narcan to the local crust punk populace, all of whom she knows by name.

“Do these people really care?” she asks.

Sadly, Basel people do seem to express more concern about French discos and wearing aggressive outfits than they do about the inequality in America—maybe best seen in Miami’s two worlds.

I have an idea for Art Basel next year. In the process of exchanging all those millions for bought and sold visions, try and help some of the people from Miami.

Are wealthy visitors obligated to alleviate some of the local misery when they party in the midst of poverty? Take a position in COMMENTS.

These are solely the author’s opinions and do not represent those of TakePart, LLC or its affiliates.

Related Stories on TakePart:

• Dispatch From Morocco: ‘Excuse Me, Aren’t We About to Start a War Here?’

• America, Syria and the State of Child Soldiering 2012

• Census Shows Sharp Increase in U.S. Poor

---

Ray LeMoine was born in Boston and lives in New York. He’s done humanitarian work in Iraq and Pakistan and has written for various media outlets, including the New York Times, New York Magazine and the Awl.

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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

An earlier version of this article misstated the prewar price, in Syrian pounds and the dollar equivalent, of an eight-loaf bag of bread in Syria. It is 15 Syrian pounds, or about 21 cents; not 25 Syrian pounds, or about 33 cents. The error was repeated in the picture caption with the earlier version.  

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Actor decapitated student, killed girlfriend, DA alleges

Clinging to keepsakes and memories more than two years after their
children were killed, the parents of two slain Orange Coast College
students say the pain of reliving the details of their deaths in court
can't match their desire for justice.

On Thursday, the families of Juri "Julie" Kibuishi, 23, and Samuel Herr, 26, sat in Orange County Superior Court
for a preliminary hearing to determine whether prosecutors could move
forward with charges of accessory after the fact against Rachel Buffett,
25, the then-fiancee of alleged killer Daniel Patrick Wozniak. Buffett is accused of helping Wozniak by lying to police after the crime.

The victims' families said that in spite of media attention garnered by the prosecution of Buffett,  who has claimed innocence of murder charges, they trust the legal system to do its job.

"We're not detectives," said Kibuishi's mother, June Kibuishi, expressing her faith in Deputy Dist. Atty. Matt Murphy. "We just want the truth."

"We're here to support Matt Murphy, the Costa Mesa Police Department
and the Orange County D.A.," said Samuel's father, Steve Herr.

Asked how he felt, Herr replied with a tired sigh. "How do you feel every day in court?"

Kibuishi said it never gets easier.

During a recess in the lengthy and at times gruesome hearing, Kibuishi tugged at a silver ring that had belonged to her daughter hanging on a chain around her neck.

"This is the only thing that we got back after it happened," she
said. "And a necklace in a little envelope. I wasn't able to see her
until the day before the service. And then we found out what happened to
Sam. Just .... " She shook her head.

"It doesn't make any sense to me," Kibuishi said. "My daughter was
not at the wrong place at the wrong time. She was used. She thought she
was helping out a friend."

Julie Kibuishi, police say, was Costa Mesa actor Wozniak's second victim.

On the afternoon of May 21, 2010, Wozniak shot and killed Herr, his upstairs neighbor, and then dismembered his body, prosecutors say. Wozniak, 28, a community theater actor, then allegedly lured Kibuishi, Herr's friend and tutor, to Herr's apartment.

When she arrived, prosecutors say Wozniak shot her and then staged her body to look as though Herr had sexually assaulted her.

To lure Kibuishi to her death, prosecutors say, Wozniak posed as Herr, using Herr's cellphone to send text messages telling her that
he was having family problems and wanted to talk to someone he could
trust.

Buffett is accused of making misleading statements to detectives investigating the slayings, including an allegedly fictitious third man who was involved in the crime. The judge Friday ultimately found there was enough evidence to move forward with the case against Buffett, but said it would be a tough case for prosecutors.

ALSO:

Helping children cope with Connecticut shooting

Maligned UC logo shelved; 'time to move on,' official says

Jenni Rivera vigil keeps growing as family plans memorial

-- Jill Cowan, Times Community News

Photo: Samuel Herr. Credit: Family photo

Read More..

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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Kelly Clarkson Is Engaged

By Mike Fleeman

12/15/2012 at 05:30 PM EST

Brandon Blackstock and Kelly Clarkson

Rick Diamond/Getty

Kelly Clarkson's wait for a ring is over.

"I'M ENGAGED!!!!!" she announced Saturday on Twitter. "I wanted y'all to know!! Happiest night of my life last night! I am so lucky and am with the greatest man ever."

The Grammy-nominated pop star, 30, and freshly minted fiancé Brandon Blackstock, a Nashville-based talent manager, began dating a year ago. Blackstock is the son of Clarkson's manager, Narvel Blackstock, who is married to Reba McEntire.

Earlier this year Clarkson joked that she was so happy it was "ruining my creativity" and that she was now "writing all this happy" stuff.

The only thing that had been missing, she said in November, was the wedding bling, and even then she was sure it would be arriving. As for her ceremony plans, she told Ellen DeGeneres: "We will totally, probably elope."

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Google+ app for Android updated with new photo-sharing features, emoticons, GIFs and more

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Foreign Minister Blames Sanctions for Syria’s Troubles

BEIRUT, Lebanon — Receiving a high-level United Nations delegation on Saturday in Damascus, Syria’s foreign minister blamed international sanctions for his country’s problems and called on the United Nations to help lift the measures, which were imposed to punish the government for its crackdown on pro-democracy protesters that spiraled into armed conflict.

Government forces continued airstrikes and artillery barrages in the suburbs of Damascus, the capital, as a top United Nations official, Valerie Amos, visited the city to investigate the needs of Syrians during a conflict that has killed more than 40,000 people and led more than a half-million to flee the country, with many more displaced inside Syria.

The civil war set off by the brutal crackdown on peaceful protests has devastated many cities and suburbs as the government levels rebellious neighborhoods and some rebels set off bombs.

But Foreign Minister Walid al-Moallem and other officials placed the blame elsewhere, according to Syrian and foreign news reports, saying, “The sanctions imposed by the United States and countries of the European Union on Syria are responsible for the suffering of the Syrian people.”

In the northern city of Aleppo, rebels claimed to have taken another important military installation, the region’s infantry school, though some reports said that fighting continued on Saturday.

There was an outpouring of grief from antigovernment activists and fighters after a commander of a rebel group, the Tawhid, or Unification, Brigade, was reported to have died in the fighting. It was an unusual moment of focus on an individual in an uprising with few widely known leaders or public faces.

The commander, Yousef al-Jader, also known as Abu Furat, had earlier recorded a statement, posted online on Saturday, that resonated with many Syrians.

“I feel very sad whenever I see a dead man, whether from our side or their side,” he said.

Speaking about President Bashar al-Assad, who has resisted calls to step down, he asked: “Why did he have to hold on to his seat? If he had resigned, we would have the best country in the world.”

Opposition members were distraught over the death of Mr. Jader, considered a skilled and respected officer by others in the loose-knit Free Syrian Army.

“A man has left our world, and men are few,” Samar Yazbek, a prizewinning novelist, wrote on Facebook, adding that Mr. Jader’s statement had made her cry. “His quavering and humanitarian voice represented, for me, the lovely and difficult future of Syria,” she wrote. “He barely lighted a star in the sky of our pain!”

The commander was one of many fighters to die in the fighting at the infantry school, which is north of Aleppo, in Muslimiyah.

A Syrian activist in the region, reached by phone, said rebels, who had breached the school’s compound several days ago and had been fighting for it building by building, had lost as many as 25 fighters there on Saturday. “It was a big victory for us, but very costly,” said the activist, Yasser al-Haji.

It is unclear whether the rebels will keep control of the base. In many cases, rebels have quickly taken ammunition from captured bases and then abandoned them, wary of government attacks.

In Jordan, officials who defected from the Syrian government announced that they had formed a new opposition group led by Mr. Assad’s former prime minister, Riyad Farid Hijab, one of the highest-ranking officials to desert during the conflict.

The group, called the National Free Coalition of the Workers of Syrian Government Institutions, aims to keep state structures intact if Mr. Assad’s government falls, Reuters reported.

The group includes Abdu Hussameldin, the former deputy oil minister, and others, who, at a news conference in Amman, expressed support for the Free Syrian Army and the National Coalition of Syrian Revolutionary and Opposition Forces, recently recognized by the United States and others as the legitimate representative of Syrians.

Fighting continued east of Damascus; activists reported airstrikes in Beit Saham, near the Damascus airport. The government claims to have pushed rebels out of some southern suburbs after heavy shelling, and is now focusing attacks in the east in an effort to seal off the capital.

While rebels appeared to make many some gains in a semicircle of suburbs around the capital in recent weeks, those were followed by a fearsome government counterattack, and some analysts have suggested that what began as a victory for the rebels has become, as has happened several times before, a defeat.

The government may have led rebels into a trap, reported the Lebanese newspaper As-Safir, a left-leaning publication that often supports the pro-Assad Lebanese group Hezbollah. Citing informed sources, the newspaper said that the government intentionally withdrew forces from some Damascus suburbs to draw rebels in, stretch their supply lines and later wipe them out.

Syrian state news media reported that Leila Zerrougui, a United Nations special representative, visited camps for families displaced by the fighting and called on all sides to protect children affected by the conflict.

Anne Barnard reported from Beirut, and C. J. Chivers from Antakya, Turkey. Hania Mourtada contributed reporting from Beirut.

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Man sought to videotape girlfriend's murder for Christmas, DA says

A south Orange County man who solicited his ex-girlfriend's murder and asked that the killing be videotaped so he could watch it on Christmas was sentenced Thursday to 31 years to life in state prison.

Mark Alan Jarosik, a Ladera Ranch resident, was in custody at the time of the murder solicitation, being held on suspicion of raping his former girlfriend.

Jarosik, 46, was found guilty in October of forcible rape, solicitation to commit murder and attempted murder with premeditation and deliberation, according to the Orange County district attorney's office.

Prosecutors said Jarosik went to the Ladera Ranch home of his 41-year-old ex-girlfriend in May 2009 to use her computer. They had broken up a month before, after living together and dating for several years.

The woman was at dinner with friends and when she returned, prosecutors said, the two got into an argument. The woman allegedly thought Jarosik had been spying on her, driving past the restaurant where she had been having dinner.

Prosecutors said the argument escalated into a physical and sexual assault, with Jarosik raping the woman.

On May 16, 2009, the incident was reported to law enforcement, and within days, prosecutors had filed rape charges. Jarosik was held in lieu of $100,000 bail. 

A protective order was issued requiring him -- should he make bail -- to stay more than 200 yards away from the woman at all times and forbidding any contact, directly or through a third party.

But after he posted bail, prosecutors said, Jarosik attempted to break into the woman's home. The woman's two children saw a hand come through a window near the front door of the house and screamed, and Jarosik fled.

The next morning, prosecutors said, Jarosik violated the protective order, attacking the woman outside her home. He pushed her to the ground, punched her in the face and banged her head against the curb, according to prosecutors.

Neighbors who witnessed the attack pulled Jarosik off of her, called authorities and pinned him down until police arrived. The woman was left in serious condition with a concussion and lacerations to the head.

While he was in custody at the Orange County Jail, prosecutors said, Jarosik asked another inmate to have a relative murder the woman, requesting that he have it videotaped.

The solicitation was never carried out.

ALSO:

State appellate court backs release of Scouts' 'perversion files'

Pilot's death in Burbank due to natural causes, authorities say

Ex-reserve deputy, security firm owner is convicted in fraud case

-- Rick Rojas and Richard Winton

Photo: Mark Alan Jarosik. Credit: Orange County District Attorney.

Read More..

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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Adam Lanza Identified as Gunman in Connecticut Shooting

By Stephen M. Silverman

12/14/2012 at 05:30 PM EST

Woman speaking with state police at the scene

Cloe Poisson/Hartford Courant/MCT/Getty

As authorities continue to investigate Friday's horrific shooting at Sandy Hook Elementary School in Newtown, Conn., details are beginning to emerge about the alleged gunman.

A law enforcement official tells the Associated Press that the shooter has been identified as 20-year-old Adam Lanza, the son of a teacher at Sandy Hook Elementary School, which is a K-4 school.

A second law enforcement official says the man's mother, Nancy Lanza, was a kindergarten teacher and is presumed dead.

Although Lanza wasn't named during a Friday afternoon press conference, Connecticut State Police spokesman Lt. Paul Vance told reporters, "The shooter is deceased inside the building."

Vance put the death toll at 28 total: 20 children, six adults, the gunman and a deceased adult at a secondary location.

There are reports that the deceased adult at a secondary location was a family member found in the Lanza family home in Newtown. No further details are available.

According to reports, the alleged shooter, armed with three weapons and wearing a bullet-proof vest, entered the grade school Friday morning. He reportedly began shooting in the principal's office, then went to the kindergarten class, where he opened fire.

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