Optimism about "cliff" boost market; financials lead

NEW YORK (Reuters) - The S&P 500 ended at its highest level in almost two months on Monday on rising hopes that negotiations over the "fiscal cliff" were making progress and that a deal could be reached in days.

After weeks of stalemate, President Barack Obama and Republican House Speaker John Boehner met at the White House on Monday, raising hopes that Washington will be able to head off steep tax hikes and spending cuts that threaten the economy.

All of the S&P 500's 10 sectors were higher, led by financials and other growth-oriented sectors. The S&P Financial Index <.gspf> gained 2.1 percent, while the S&P consumer discretionary sector <.gspd> was up 1.8 percent.

Investors worry the U.S. economy could slide into recession if the tax and spending changes are implemented.

Boehner has edged closer to Obama's position by proposing to extend lower tax rates for everyone who earns less than $1 million. Still, his position remains far from that of President Obama.

"Trumping everything right now are the fiscal cliff talks. It seems like progress is being made. I think it's getting to the nitty gritty," said Alan Lancz, president of Alan B. Lancz & Associates Inc. in Toledo, Ohio. "The bet right now is that something will come by the end of this week."

The Dow Jones industrial average <.dji> was up 100.38 points, or 0.76 percent, at 13,235.39. The Standard & Poor's 500 Index <.spx> was up 16.78 points, or 1.19 percent, at 1,430.36, its highest close since October 22. The Nasdaq Composite Index <.ixic> was up 39.27 points, or 1.32 percent, at 3,010.60.

The gains, which came on lighter-than-usual volume, ended a two-day losing streak on the S&P 500. The index also had its best daily percentage gain since November 23. Volume was roughly 6.2 billion shares traded on the New York Stock Exchange, the Nasdaq and the NYSE MKT, compared with the year-to-date average daily closing volume of 6.4 billion.

In the financial sector, shares of Bank of America rose 4 percent to $11. American International Group Inc. shares rose 3 percent to $34.95 on plans to sell as much as $6.5 billion of AIA Group Ltd. Advancing stocks included those in the home construction sector <.djushb>, which rose 4.5 percent.

"People are looking for sectors to play, and I think Bank of America broke out of some long-standing price levels, and it got everything going in that sector," said Rick Meckler, president of investment firm LibertyView Capital Management in Jersey City, New Jersey.

Clearwire Corp agreed to sell the rest of the company to Sprint Nextel Corp for a slightly sweetened $2.2 billion offer just days after minority shareholders criticized the previous bid as too low. Clearwire tumbled 13.6 percent to $2.91, while Sprint was up 0.2 percent to $5.56.

Apple Inc shares edged up after recent losses, rising 1.8 percent to $518.83 even though two firms cut their price targets on the stock Monday.

The tech giant said it sold more than 2 million of its new iPhone 5 smartphones in China during the three days after its launch there on Friday, but the figures did not ease worries about stiffer competition. Apple shares have tumbled more than 25 percent in about three months.

Compuware Corp rose 12.9 percent to $10.76 after hedge fund Elliott Management offered to buy the business software maker for $2.3 billion and S&P Capital IQ raised the target price and moved it to "hold" from "strong sell.

(Editing by Kenneth Barry and Nick Zieminski)

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Syrian Airstrike Kills Palestinian Refugees

DAMASCUS, Syria — Syrian government forces for the first time hit the country’s largest Palestinian refugee neighborhood with airstrikes on Sunday, killing at least eight people in the Yarmouk district of Damascus and reportedly driving dozens of formerly pro-government Palestinian fighters to defect to the rebels.

New signs emerged on Sunday of political pressure on President Bashar al-Assad. Mr. Assad’s vice president was quoted as saying neither side could win the war and calling for “new partners” in a unity government, a possible sign that at least some in the government were exploring new ways out of the crisis. The comments came as two close allies, the government of Iran and the leader of the Lebanese Shiite group Hezbollah, appeared to slightly temper their support.

In Yarmouk, flesh stuck to the walls and burned body parts littered the ground at the Sheik Abdul Qader mosque, which had offered shelter to Palestinians and others displaced by fighting in other areas. Minutes before, a reporter saw a Syrian fighter jet fire rockets at the camp. Women, crying children and white-bearded men thronged the streets with hurriedly packed bags, not sure where to look for safety.

For many Yarmouk residents — refugees from conflict with Israel and their descendants — the attacks shattered what was left of the Syrian government’s claim to be a champion and protector of Palestinians, a position that the Assad family relied upon as a source of domestic and international legitimacy during more than 40 years of iron-fisted rule.

“For decades the Assad regime was talking about the Palestinians’ rights,” said a Palestinian refugee who gave his name as Abu Ammar as he debated whether to flee with his wife and five children from the camp, on the southern edge of Damascus. “But Bashar al-Assad has killed more of us today than Israel did in its latest war on Gaza.”

He added: “What does Bashar expect from us after today? All of us will be Free Syrian Army fighters.”

The Palestinian militant group and political party Hamas has broken with Mr. Assad over his crackdown on what began as a peaceful protest movement, and while most Palestinian parties still profess neutrality, a growing number of Palestinians support — and have even joined — the rebels.

The Syrian government long held the loyalty of hundreds of thousands of Palestinian refugees, giving them health care, education, and access to professional careers, among other rights denied by other Arab host countries. But those policies also gave Palestinians a stake and sense of belonging in Syria that has led many to join the uprising.

Several of Mr. Assad’s allies signaled a new push for a peaceful solution. Iran’s Foreign Ministry called for an end to military action, the release of political prisoners and a broad-based dialogue to form a transitional government that would hold free elections, Iran’s state news agency reported.

Mr. Assad’s vice president, Farouk al-Shara, said that neither the government nor the rebels could end the conflict militarily, the pro-Syrian Lebanese newspaper Al Akhbar reported. And he called for a solution involving a cease-fire and brokered by international leaders that would establish a “national unity government with wide powers.”

He added that the battle was for the country’s very existence, not “the survival of an individual or a regime,” and that Syria’s leaders “cannot achieve change without new partners.”

The impact of the statements was unclear. Mr. Shara, a Sunni Muslim like most of the rebels, has been floated by the Arab League as a possible successor, but many of Mr. Assad’s opponents reject any dealings with leaders of the current government.

In neighboring Lebanon, Hassan Nasrallah, the leader of Hezbollah, appeared to acknowledge for the first time that the Syrian uprising is at least in part driven by popular sentiment.

“Today, in Syria,” he said in a videotaped address at a graduation ceremony, “there is a big part of the population with the Syrian regime and a part against it, and the latter armed themselves to fight the regime.”

An employee of The New York Times reported from Damascus, and Anne Barnard from Beirut. Hania Mourtada contributed reporting from Beirut, and Hala Droubi from Dubai.

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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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Which Les Misérables Star Did You Pick as Best Dressed This Week?

Stylewatch
Style News Now

12/15/2012 at 12:00 PM ET

FameFlynet

Her costar Anne Hathaway had everyone talking this week, but Amanda Seyfried seemingly earned the last word: 16,000 of you voted her gorgeous gown the number-one dress of the week.

The winning Alexander McQueen creation, worn to the Les Misérables premiere in N.Y.C. on Monday, featured a golden embroidered bodice, a tortoiseshell belt and black skirt.

PHOTOS: SEE THE TOP 10 BEST DRESSED STARS ON PEOPLE THIS WEEK! 

Seyfried finished off the regal design with a braided crown, Harry Winston jewels and a smoky eye.

Coming in a close second was last week’s best dressed star, Katie Holmes, in a grape Vivienne Westwood column gown paired with emerald satin Roger Vivier sandals for a Broadway Dreams Foundation party in N.Y.C. on Monday.

Click here to find out who else ranked in the top 10 and vote for your favorite celeb looks. Tell us: Who do you think had better Les Mis red carpet premiere style: Seyfried or Hathaway? Sound off in the comments.

–Jennifer Cress

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Experts: No link between Asperger's, violence

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

__

AP Writer Matt Apuzzo contributed to this report.

___

Online:

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

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

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

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

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

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

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

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

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

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

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

BEWARE OF THE WITCH

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

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

RETHINKING APPLE

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

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

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

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

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

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

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With E.C.B. in Spotlight, Bundesbank Finds Itself in the Shadows

Mustafah Abdulaziz for The New York Times

The Bundesbank, Germany’s central bank, built in 1967 in Frankfurt.

FRANKFURT — The exposed-concrete slab of the Bundesbank headquarters stands like a bulwark outside the downtown financial district here, a stolid, Brutalist structure that in its sheer mass evokes not just the German central bank’s stubborn resistance to change but, above all, its obsessive commitment to crushing inflation.

Built 45 years ago, the modernist building is hardly old by European standards, yet it is a temple to tradition, embodying the ethos of this most conservative of institutions. “We are trying to keep it just the way it is,” said Reiner Bruckhaus, head of the bank’s centralized construction management division.

That starts with the granite floors, the Barcelona chairs in the lobby (designed by the Bauhaus great Ludwig Mies van der Rohe), and the grand, white Carrara marble by the elevators, and goes all the way up to the wood grid ceilings on the top floor. “You will find not even the slightest changes,” Mr. Bruckhaus said.

When the building was erected in 1967, the Bundesbank’s dominance in European monetary policy went unchallenged. But in the hazy distance of the Frankfurt skyline, significant change is evident in the outline of two towers and three cranes, the new headquarters of the European Central Bank — a visible reminder of the institution that has supplanted the Bundesbank, just as the euro replaced the German mark.

European leaders established the European Central Bank’s headquarters in Frankfurt as a symbol of its status as heir to the Bundesbank. But the danger posed by Europe’s continuing debt crisis demanded improvisations at odds with the Bundesbank’s conservative teachings.

Over the summer the E.C.B.’s president, Mario Draghi, pursued an expansive policy that was anathema to the old guard, whose cause was championed by the Bundesbank’s youthful president, Jens Weidmann. He and his supporters base their views not, they say, on rigid orthodoxy but on experience gleaned from the disaster of hyperinflation and the success of adhering to a hard-money path.

In an increasingly uncomfortable pairing, the Bundesbank functions as the largest piece of the E.C.B. puzzle. With more than 9,500 full-time workers, the Bundesbank dwarfs the 1,600-strong central bank. Because of that limited staff, the E.C.B. depends on the Bundesbank to handle many of the back-office functions of the common currency.

But the European Central Bank’s influence continues to grow. Euro-zone finance ministers agreed to a deal Thursday to put 100 to 200 of their largest banks under its direct supervision.

The arranged marriage between the two banks will take enormous effort and flexibility. As its massive headquarters suggests, the Bundesbank is capable of enormous and sustained effort, but flexibility may be inimical to its nature.

Founded in 1957, the Bundesbank quickly grew into one of Germany’s most respected institutions. The rank-and-file behind Mr. Weidmann, 44, represent an unusually tight-knit group, almost like a monastic order, and they are steeped in the bank’s secular religion — often at the bank’s own school, a kind of Hogwarts for its future financial wizards, in a hilltop 12th-century castle in the town of Hachenburg.

“You hear it in the first lecture,” said Silke Frühklug, 32, a graduate and Bundesbank employee. “You hear it in the last lecture and every day in between: price stability.”

Ms. Frühklug married a classmate and in her free time plays on the central bank’s badminton team, which on a recent evening practiced in a gymnasium on the Bundesbank campus right after the handball team. The bank also has a theater society and “hobby artists” club, which exhibits in the lobby of the headquarters. It owns apartments for workers in tight real-estate markets like Munich and here in Frankfurt. Retired employees still lunch at the cafeteria, helping to nurture the all-important continuity.

“People feel connected with the goals of the bank,” said Matthias Endres, 43, editor of the Bundesbank’s internal magazine. Like Ms. Frühklug, he married a fellow graduate from the school in Hachenburg. He has vacationed with his wife and their three children at all three of the Bundesbank getaways, on the North Sea, in the Black Forest and on a lake in Bavaria.

Mr. Endres’s wife, Simone, works part-time in the headquarters’ Money Museum, which houses some 350,000 objects, of which roughly 1,300 are on display, including the worthless bills in denominations of millions and billions from the hyperinflation of the Weimar-era and examples of commodity money, like a gold bar, a tea brick and even a preserved cow standing near the entrance, a silent bovine greeter.

Jack Ewing contributed reporting.

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Jeff Probst Shares His Thoughts on Who Could Win Survivor

TV Watch

Survivor

By Steve Helling

12/15/2012 at 04:10 PM EST

Jeff Probst ;Malcolm Freberg
Lisa Whelchel
Denise Stapley
Mike Skupin

Monty Brinton/CBS(5)

In the 25 seasons that Jeff Probst has hosted Survivor, he has presided over 399 tribal councils.

Since the show's debut 12 years ago, 384 contestants have played the game, with 43 of them competing more than once. Seven contestants have quit; ten have been medically evacuated and 23 people have walked away with $1 million and the title of Sole Survivor. (Sandra Diaz-Twine is the only contestant to win the game twice.)

Why all the statistics? Because it just goes to show that Probst knows a thing or two about how to win this game. Here, he evaluates the strengths and weaknesses of the final four contestants of Survivor: Philippines for PEOPLE. Who will walk away with the million-dollar prize on Sunday night? Probst won't find out until the live finale with the rest of us, but here's his expert take on everyone's chances.

MALCOLM FREBERG
"If he can win his way to the final tribal council, I think he wins against anybody," says Probst. "He's played a beautiful game combining physical skills with great social skills. People like him, he's an underdog and he hasn't lied. If he doesn't win the final immunity challenge, he has no chance. Nobody is going to take him to the end."

LISA WHELCHEL
Unless something goes terribly wrong, Lisa will be in the final tribal council. The question is: Who will be there with her? Lisa has a good story – she has overcome a lot. Her biggest challenge will be getting sympathy from the jury. It's much easier for the audience who sees all of her interviews. The other players may see her as a whiner. She will need an amazing speech at the final tribal if she is to beat Malcolm or Denise.

DENISE STAPLEY
If she gets to the end with anyone other than Malcolm, she will most likely win. She has the biggest underdog story having survived the worst tribe and going to every tribal council. She has also played a brilliant social game. Her best bet is to go to the final with Lisa and/or Skupin.

MIKE SKUPIN
He's the longshot only because of his competition. Skupin is seen as a bit of goofball. He has a "go for broke" attitude and, as a result, he is as likely to fumble the ball as he is to score the touchdown. It's a great way to play Survivor and it got him this far, but in a game in which the jury is looking for any reason to criticize, Skupin may have given them too much.

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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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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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