A children's choir opens 'SNL' with 'Silent Night'

NEW YORK (AP) — "Saturday Night Live" made a rare departure from its comedic opening to pay tribute to the children and adults killed at a Connecticut elementary school.

Not known for treating anything seriously or tenderly, the show made a fitting exception during the first moments of its show Saturday. Rather than the usual comedic sketch, a children's choir appeared on camera and angelically sang "Silent Night," with the touching refrain, "Sleep in heavenly peace."

Then the members of the New York City Children's Chorus shouted out the NBC show's time-honored introduction: "Live from New York, it's 'Saturday Night!'"

It was the night's sole reference to the tragedy and struck just the right tone.

Later, the chorus returned to join musical guest Paul McCartney in a rendition of his "Wonderful Christmas Time."

Appearing in a sketch in an unbilled cameo, actor Samuel L. Jackson made a distinctive contribution of his own.

Pretending to be miffed at getting interrupted as a guest on the mock talk show "What Up with That?" Jackson said what sounded very much like an F-bomb, followed by the term sometimes shortened to "B.S."

Playing the host of "What Up with That?" Kenan Thompson looked startled by Jackson's vulgarities but kept going.

"C'mon, Sam. That costs money!" he quipped, cracking up the studio audience.

Moments after the show ended, Jackson tried to explain in a Twitter posting.

"I only said FUH," he insisted, adding that Thompson was supposed to cut him off with his second eruption, but "blew it!!"

Jackson's tweet was accompanied by a photo of himself looking mortified.

Besides Jackson, some of the stars dropping by for this special Christmas "SNL" included Alec Baldwin, Tom Hanks, Kristen Wiig, Jimmy Fallon and Tina Fey. The guest host was Martin Short.

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Online: www.nbc.com

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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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'Always smiling': Portraits of Connecticut victims

Most died at the very start of their young lives, tiny victims taken in a way not fit for anyone regardless of age. Others found their life's work in sheltering little ones, teaching them, caring for them, treating them as their own. After the gunfire ended Friday at Sandy Hook Elementary School, the trail of loss was more than many could bear: 20 children and six adults at the school, the gunman's mother at home, and the gunman himself.

A glimpse of some of those who died:

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Charlotte Bacon, 6, student

They were supposed to be for the holidays, but finally on Friday, after much begging, Charlotte Bacon's mother relented and let her wear the new pink dress and boots to school.

It was the last outfit the outgoing redhead would ever pick out. Charlotte's older brother, Guy, was also in the school but was not shot.

Her parents, JoAnn and Joel, had lived in Newtown for four or five years, JoAnn's brother John Hagen, of Nisswa, Minn., told Newsday.

"She was going to go some places in this world," Hagen told the newspaper. "This little girl could light up the room for anyone."

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Olivia Engel, 6, student

The images of Olivia Engel will live far beyond her short lifetime. There she is, visiting with Santa Claus, or feasting on a slice of birthday cake. There's the one of her swinging a pink baseball bat, and another posing on a boat. In some, she models a pretty white dress; in others, she makes a silly face.

Dan Merton, a longtime friend of the girl's family, says he could never forget the child, and he has much to say when he thinks of her.

"She loved attention," he said. "She had perfect manners, perfect table manners. She was the teacher's pet, the line leader."

On Friday, Merton said, she was simply excited to go to school and then return home and make a gingerbread house.

"Her only crime," he said, "is being a wiggly, smiley 6-year-old."

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Dawn Hochsprung, 47, principal

Dawn Hochsprung's pride in Sandy Hook Elementary was clear. She regularly tweeted photos from her time as principal there, giving indelible glimpses of life at a place now known for tragedy. Just this week, it was an image of fourth-graders rehearsing for their winter concert; days before that, the tiny hands of kindergartners exchanging play money at their makeshift grocery store.

She viewed her school as a model, telling The Newtown Bee in 2010 that "I don't think you could find a more positive place to bring students to every day." She had worked to make Sandy Hook a place of safety, too, and in October, the 47-year-old Hochsprung shared a picture of the school's evacuation drill with the message "safety first." When the unthinkable came, she was ready to defend.

Officials said she died while lunging at the gunman in an attempt to overtake him.

"She had an extremely likable style about her," said Gerald Stomski, first selectman of Woodbury, where Hochsprung lived and had taught. "She was an extremely charismatic principal while she was here."

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Madeleine Hsu, 6, student

Dr. Matthew Velsmid was at Madeleine's house on Saturday, tending to her stricken family. He said the family did not want to comment.

Velsmid said that after hearing of the shooting, he went to the triage area to provide medical assistance but there were no injuries to treat.

"We were waiting for casualties to come out, and there was nothing. There was no need, unfortunately," he said. "This is the darkest thing I've ever walked into, by far."

Velsmid's daughter, who attends another school, lost three of her friends.

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Catherine Hubbard, 6, student

A family friend turned reporters away from the house, but Catherine's parents released a statement expressing gratitude to emergency responders and for the support of the community.

"We are greatly saddened by the loss of our beautiful daughter, Catherine Violet and our thoughts and prayers are with the other families who have been affected by this tragedy," Jennifer and Matthew Hubbard said. "We ask that you continue to pray for us and the other families who have experienced loss in this tragedy."

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Chase Kowalski, 7, student

Chase Kowalski was always outside, playing in the backyard, riding his bicycle. Just last week, he was visiting neighbor Kevin Grimes, telling him about completing — and winning — his first mini-triathlon.

"You couldn't think of a better child," Grimes said.

Grimes' own five children all attended Sandy Hook, too. Cars lined up outside the Kowalskis' ranch home Saturday, and a state trooper's car idled in the driveway. Grimes spoke of the boy only in the present tense.

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Nancy Lanza, 52, gunman's mother

She once was known simply for the game nights she hosted and the holiday decorations she put up at her house. Now Nancy Lanza is known as her son's first victim.

Authorities say her 20-year-old son Adam gunned her down before killing 26 others at Sandy Hook. The two shared a home in a well-to-do Newtown neighborhood, but details were slow to emerge of who she was and what might have led her son to carry out such horror.

Kingston, N.H., Police Chief Donald Briggs Jr. said Nancy Lanza once lived in the community and was a kind, considerate and loving person. The former stockbroker at John Hancock in Boston was well-respected, Briggs said.

Court records show Lanza and her ex-husband, Peter Lanza, filed for divorce in 2008. He lives in Stamford and is a tax director at General Electric. A neighbor, Rhonda Cullens, said she knew Nancy Lanza from get-togethers she had hosted to play Bunco, a dice game. She said her neighbor had enjoyed gardening.

"She was a very nice lady," Cullens said. "She was just like all the rest of us in the neighborhood, just a regular person."

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Jesse Lewis, 6, student

Six-year-old Jesse Lewis had hot chocolate with his favorite breakfast sandwich — sausage, egg and cheese — at the neighborhood deli before going to school Friday morning.

Jesse and his parents were regulars at the Misty Vale Deli in Sandy Hook, Conn., owner Angel Salazar told The Wall Street Journal.

"He was always friendly; he always liked to talk," Salazar said.

Jesse's family has a collection of animals he enjoyed playing with, and he was learning to ride horseback.

Family friend Barbara McSperrin told the Journal that Jesse was "a typical 6-year-old little boy, full of life."

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Ana Marquez-Greene, 6, student

A year ago, 6-year-old Ana Marquez-Greene was reveling in holiday celebrations with her extended family on her first trip to Puerto Rico. This year will be heartbreakingly different.

The girl's grandmother, Elba Marquez, said the family moved to Connecticut just two months ago, drawn from Canada, in part, by Sandy Hook's sterling reputation. The grandmother's brother, Jorge Marquez, is mayor of a Puerto Rican town and said the child's 9-year-old brother also was at the school but escaped safely.

Elba Marquez had just visited the new home over Thanksgiving and is perplexed by what happened. "What happened does not match up with the place where they live," she said.

A video spreading across the Internet shows a confident Ana hitting every note as she sings "Come, Thou Almighty King." She flashes a big grin and waves to the camera when she's done.

Jorge Marquez confirmed the girl's father is saxophonist Jimmy Greene, who wrote on Facebook that he was trying to "work through this nightmare."

"As much as she's needed here and missed by her mother, brother and me, Ana beat us all to paradise," he wrote. "I love you sweetie girl."

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James Mattioli, 6, student

The upstate New York town of Sherrill is thinking of Cindy Mattioli, who grew up there and lost her son James in the school shooting in Connecticut.

"It's a terrible tragedy, and we're a tight community," Mayor William Vineall told the Utica Observer-Dispatch. "Everybody will be there for them, and our thoughts and prayers are there for them."

James' grandparents, Jack and Kathy Radley, still live in the city, the newspaper reported.

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Anne Marie Murphy, 52, teacher

A happy soul. A good mother, wife and daughter. Artistic, fun-loving, witty and hardworking.

Remembering their daughter, Anne Marie Murphy, her parents had no shortage of adjectives to offer Newsday. When news of the shooting broke, Hugh and Alice McGowan waited for word of their daughter as hours ticked by. And then it came.

Authorities told the couple their daughter was a hero who helped shield some of her students from the rain of bullets. As the grim news arrived, the victim's mother reached for her rosary.

"You don't expect your daughter to be murdered," her father told the newspaper. "It happens on TV. It happens elsewhere."

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Emilie Parker, 6, student

Quick to cheer up those in need of a smile, Emilie Parker never missed a chance to draw a picture or make a card.

Her father, Robbie Parker, fought back tears as he described the beautiful, blond, always-smiling girl who loved to try new things, except foods.

Parker, one of the first parents to publicly talk about his loss, expressed no animosity for the gunman, even as he struggled to explain the death to his other two children, ages 3 and 4. He's sustained by the fact that the world is better for having had Emilie in it.

"I'm so blessed to be her dad," he said.

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Noah Pozner, 6, student

The way Noah Pozner's parents saw it, no schools in New York could compare with those in Newtown, a relative told Newsday. So they moved their family — Noah, his twin sister and his 8-year-old sister.

"At this stage, two out of three survived. ... That's sad," said Noah's uncle Arthur Pozner, of New York City's Brooklyn borough. "The reason they moved to that area is because they did not consider any school in New York state on the same level. That's one of the reasons they moved, for safety and education."

Noah's siblings were also students there but were not hurt. Noah's uncle recalled him as "extremely mature."

"When I was his age, I was not like him," Pozner told the newspaper. "Very well brought up. Extremely bright. Extremely bright."

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Lauren Gabrielle Rousseau, 30, teacher

Lauren Rousseau had spent years working as a substitute teacher and doing other jobs. So she was thrilled when she finally realized her goal this fall to become a full-time teacher at Sandy Hook.

Her mother, Teresa Rousseau, a copy editor at the Danbury News-Times, released a statement Saturday that said state police told them just after midnight that she was among the victims.

"Lauren wanted to be a teacher from before she even went to kindergarten," she said. "We will miss her terribly and will take comfort knowing that she had achieved that dream."

Her mother said she was thrilled to get the job.

"It was the best year of her life," she told the newspaper.

Rousseau has been called gentle, spirited and active. She had planned to see "The Hobbit" with her boyfriend Friday and had baked cupcakes for a party they were to attend afterward. She was born in Danbury, and attended Danbury High, college at the University of Connecticut and graduate school at the University of Bridgeport.

She was a lover of music, dance and theater.

"I'm used to having people die who are older," her mother said, "not the person whose room is up over the kitchen."

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Mary Sherlach, 56, school psychologist

When the shots rang out, Mary Sherlach threw herself into the danger.

Janet Robinson, the superintendent of Newtown Public Schools, said Sherlach and the school's principal ran toward the shooter. They lost their own lives, rushing toward him.

Even as Sherlach neared retirement, her job at Sandy Hook was one she loved. Those who knew her called her a wonderful neighbor, a beautiful person, a dedicated educator.

Her son-in-law, Eric Schwartz, told the South Jersey Times that Sherlach rooted on the Miami Dolphins, enjoyed visiting the Finger Lakes, relished helping children overcome their problems. She had planned to leave work early on Friday, he said, but never had the chance. In a news conference Saturday, he told reporters the loss was devastating, but that Sherlach was doing what she loved.

"Mary felt like she was doing God's work," he said, "working with the children."

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Victoria Soto, 27, teacher

She beams in snapshots. Her enthusiasm and cheer was evident. She was doing, those who knew her say, what she loved.

And now, Victoria Soto is being called a hero.

Though details of the 27-year-old teacher's death remained fuzzy, her name has been invoked again and again as a portrait of selflessness and humanity among unfathomable evil. Those who knew her said they weren't surprised by reports she shielded her first-graders from danger.

"She put those children first. That's all she ever talked about," said a friend, Andrea Crowell. "She wanted to do her best for them, to teach them something new every day."

Photos of Soto show her always with a wide smile, in pictures of her at her college graduation and in mundane daily life. She looks so young, barely an adult herself. Her goal was simply to be a teacher.

"You have a teacher who cared more about her students than herself," said Mayor John Harkins of Stratford, the town Soto hailed from and where more than 300 people gathered for a memorial service Saturday night. "That speaks volumes to her character, and her commitment and dedication."

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Associated Press writers Denise Lavoie, Mark Scolforo, Allen Breed and Danica Coto contributed to this report.

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Sympathy over US school shooting stretches globe

BANGKOK (AP) — Images of a tearful President Barack Obama speaking after a shooting rampage in Connecticut resonated around the world, with many outside the United States expressing hope Saturday that America's latest school massacre would prompt the country to strengthen gun control.

Shock and sympathy were the initial reactions to the rampage that left 28 people dead, including 20 children at an elementary school. Australian Prime Minister Julia Gillard described the attack as a "senseless and incomprehensible act of evil."

"Like President Obama and his fellow Americans, our hearts too are broken," Gillard said in a statement, referring to the U.S. leader's emotional expression of condolence.

The gunman killed his mother at their home before opening fire Friday inside the school in Newtown, Connecticut, where he killed 26 people, including 20 children, police said. The killer, identified as 20-year-old Adam Lanza, then committed suicide.

Australia confronted a similar tragedy in 1996, when a man went on a shooting spree in the southern state of Tasmania, killing 35 people. The mass killing sparked outrage across the country and led the government to impose strict new gun laws, including a ban on semi-automatic rifles.

Gillard's sentiments echoed those of British Prime Minister David Cameron, who said he "was shocked and deeply saddened" to learn of the "horrific shooting."

"My thoughts are with the injured and those who have lost loved ones," he said. "It is heartbreaking to think of those who have had their children robbed from them at such a young age, when they had so much life ahead of them."

Initial official reaction at the national level did not touch on perceptions of the United States as a violent society, or its generally lax gun laws. On social media sites such as Twitter and in mainstream media outlets, however, there were plenty of comments about the causes of such incidents.

The attack quickly dominated public discussion in China, rocketing to the top of topic lists on social media and becoming the top story on state television's main noon newscast.

China has seen several rampage attacks at schools in recent years, though the attackers there usually use knives. The most recent attack happened Friday, when a knife-wielding man injured 22 children and one adult outside a primary school in central China.

Much of the discussion after the Connecticut rampage centered on the easy access to guns in America, unlike in China, where even knives are sometimes banned from sale. But with more than 100,000 Chinese studying in U.S. schools, a sense of shared grief came through.

"Parents with children studying in the U.S. must be tense. School shootings happen often in the U.S. Really, can't politicians put away politics and prohibit gun sales?" Zhang Xin, a wealthy property developer, wrote on her feed on the Twitter-like Sina Weibo service, where she has 4.9 million followers. "There will always be mental patients among us. They should not be given guns."

In India, Kiran Bedi, a retired pioneering policewoman who is now a major anti-corruption activist, expressed her concerns, tweeting in the shorthand style familiar to users of text services that: "Firearms in hands of unbalanced r security threat! Gun/even Driving license issue needs due diligence! They r responsibility before a right!"

Some in South Korea, whose government does not allow people to possess guns privately, blamed a lack of gun control in the United States for the high number of deaths in the Connecticut shooting. Most people on the Internet expressed utter shock at the scale of the tragedy, many of them calling it frightful and unimaginable and expressing condolences to the families of the victims.

Chosun Ilbo, South Korea's top daily, speculated in an online report that it appears "inevitable" that the shooting will prompt the U.S. government to consider tighter gun control.

In Thailand, which has one of Asia's highest rates of murder by firearms and has seen schools attacked by Islamist insurgents in its southern provinces, a columnist for the English-language daily newspaper The Nation blamed American culture for fostering a climate of violence.

"Repeated incidents of gunmen killing innocent people have shocked the Americans or us but also made most people ignore it quickly," Thanong Khanthong wrote on Twitter. "Because each Hollywood movie, namely Batman and Spiderman, have hidden the message of violence and brutal killings."

"Intentionally or not, Hollywood and video games have prepared people's mind to see killings and violence as normal and acceptable," he wrote.

In Japan, where guns are severely restricted and there are extremely few gun-related crimes, public broadcaster NHK led the noon news Saturday with the shooting, putting it ahead of an update on the final day of campaigning before Sunday's nationwide parliamentary elections.

NHK, which had a reporter giving a live broadcast from the scene, said that five of the children at the school were Japanese, and that all five were safe. Its report could not immediately be independently confirmed.

Several Japanese broadcasters ran footage from Newtown, showing scenes of people singing outside churches Friday evening, as well as part of Obama's tearful press conference.

Condolences poured in also from Baghdad.

"We feel sorry for the victims and their families. And this tragic incident shows there is no violence-free society in the world, even in Western and non-Muslim countries," said Hassan Sabah, 30, owner of stationary shop in eastern Baghdad.

Samir Abdul-Karim, a 40-year-old government employee from eastern Baghdad said that "this attack shows clearly that U.S. society is not perfect and the Americans do have people with criminal minds and who are ready to kill for the silliest reasons.

"This ugly attack against innocent children should be condemned and it shows that such acts of violence are not limited to Islamic countries such as Iraq and Afghanistan. If such attack happened in Iraq or Afghanistan, I am sure that the U.S. media would have seized the chance to depict the Arabs or Muslims as savage people who do not hesitate to kill children. "

Japanese Prime Minister Yoshihiko Noda sent a condolence message to Obama. "We express our condolences to the families of the victims," he said. "The sympathy of the Japanese people is with the American people."

In the Philippines, a society often afflicted by gun violence, President Benigno Aquino III said he and the Filipino people stand beside the United States "with bowed heads, yet in deep admiration over the manner in which the American people have reached out to comfort the afflicted, and to search for answers that will give meaning and hope to this grim event.

"We pray for healing, and that this heartbreak will never be visited on any community ever again," Aquino said in a statement tweeted by deputy presidential spokesman Abigail Valte.

Jose Manuel Barroso, president of the European Union's executive Commission, said that "''Young lives full of hope have been destroyed. On behalf of the European Commission and on my own behalf, I want to express my sincere condolences to the families of the victims of this terrible tragedy."

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Associated Press writers Thanyarat Doksone in Bangkok, Cassandra Vinograd in London, Kristen Gelineau in Sydney, Malcolm Foster and Mari Yamaguchi in Tokyo, Charles Hutzler in Beijing, Ravi Nessman in New Delhi, Sam Kim in Seoul, South Korea, Oliver Teves in Manila, Philippines, Sameer N. Yacoub in Baghdad, and Don Melvin in Brussels contributed to this report.

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School shooting postpones Cruise premiere in Pa.

NEW YORK (AP) — The U.S. premiere of the Tom Cruise action movie "Jack Reacher" is being postponed following the deadly Connecticut school shooting.

Paramount Pictures says "out of honor and respect for the families of the victims" the premiere won't take place Saturday in Pittsburgh, where "Jack Reacher" was filmed.

The premiere would've been Cruise's first U.S. media appearance since his split from Katie Holmes over the summer. It was to be more contained with select outlets covering and a location away from Hollywood or New York.

A proclamation ceremony for Cruise had been planned with Pennsylvania Gov. Tom Corbett and Pittsburgh Mayor Luke Ravenstahl.

No new date for the premiere has been set. The movie opens Dec. 21.

Friday's massacre at a Newtown, Conn., elementary school killed 20 children and several adults.

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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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Connecticut school shooting: Officials ask why

The FBI is in at least three states interviewing relatives and friends of the elementary school gunman who killed 20 children, seven adults and himself, trying to put together a better picture of the shooter and uncover any possible explanation for the massacre, ABC News has learned.

The authorities have fanned out to New Jersey, Connecticut and Massachusetts to interview relatives of Adam Lanza, 20, and his mother, who was one of Lanza's shooting victims.

The victims died Friday when Lanza invaded Sandy Hook Elementary School in Newtown, Conn., and sprayed staff and students with bullets, officials said. Lanza also was found dead in the school.

Lt. Paul Vance said 18 children died in the school and two more died later in a hospital.

Six adults also were slain, bringing the total to 26. Among them was the school's principal, Dawn Hochsprung, multiple sources told ABC News. Another adult victim was teacher Vicki Soto, his cousin confirmed.

In addition to the casualties at the school, Lanza's mother, Nancy Lanza, was killed in her home, federal and state sources told ABC News.

According to sources, Lanza shot his mother in the face, then left his house armed with at least two semi-automatic handguns, a Glock and a Sig Sauer, and a semi-automatic rifle. He was also wearing a bulletproof vest.

READ: Connecticut Shooter Adam Lanza: 'Obviously Not Well'

Lanza then drove to the elementary school and continued his rampage, authorities said.

It appeared that Lanza died from what was believed to be a self-inflicted gunshot wound. The rifle was found in his car.

"Evil visited this community today," Gov. Dan Malloy said at a news conference Friday evening.

CLICK HERE for more photos from the scene.

In the early confusion surrounding the investigation, federal sources initially identified the suspect as Adam's older brother Ryan Lanza, 24. Identification belonging to Ryan Lanza was found at the shooting scene, federal sources told ABC News.

Ryan Lanza soon took to Facebook to say he was alive and not responsible for the shooting. He later was questioned by police.

During the rampage, first-grade teacher Kaitlin Roig, 29, locked her 14 students in a class bathroom and listened to "tons of shooting" until police came to help.

"It was horrific," Roig said. "I thought we were going to die."

She said that the terrified kids were saying, "I just want Christmas. ... I don't want to die. I just want to have Christmas."

A tearful President Obama said Friday that there was "not a parent in America who doesn't feel the overwhelming grief that I do."

The president had to pause to compose himself after saying these were "beautiful little kids between the ages of 5 and 10."

As he continued with his statement, Obama wiped away tears from each eye. He has ordered flags flown as half staff.

It is the second worst mass shooting in U.S. history, exceeded only by the Virginia Tech shooting in 2007 when 32 were killed before the shooter turned the gun on himself. The carnage in Connecticut exceeded the 1999 Columbine High School shooting in which 13 died and 24 were injured.

Friday's shooting came three days after masked gunman Jacob Roberts opened fire in a busy Oregon mall, killing two before turning the gun on himself.

The Connecticut shooting occurred at the Sandy Hook Elementary School, which includes 450 students in grades K-4. The town is located about 12 miles east of Danbury, Conn.

The massacre prompted the town of Newtown to lock down all its schools and draw SWAT teams to the school, authorities said.

State Police received the first 911 call at 9:41 a.m. and immediately began sending emergency units from the western part of the state. Initial 911 calls said multiple students were trapped in a classroom, possibly with a gunman, according to a Connecticut State Police source.

Vance said on-duty and off-duty officers swarmed to the school and quickly checked "every door, every crack, every crevice" in the building looking for the gunman and evacuating children.

Soon, state police from across western Connecticut would be there. And they would be joined by FBI SWAT and evidence teams as well as members of the federal Bureau of Alcohol Tobacco and Firearms.

A photo from the scene showed a line of distressed children being led out of the school.

Three patients were taken to Danbury Hospital, which also went on lockdown, according to the hospital's Facebook page.

ABC News' Michael S. James contributed to this report.

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Pentagon to send missiles, 400 troops to Turkey

INCIRLIK AIR BASE, Turkey (AP) — The Pentagon says it will send Patriot air defense missiles and 400 troops to Turkey as part of a NATO force meant to protect Turkish territory from potential Syrian missile attack.

Pentagon press secretary George Little said Defense Secretary Leon Panetta signed a deployment order Friday en route to Turkey from Afghanistan.

The order calls for 400 U.S. soldiers to operate two batteries of Patriots at undisclosed locations in Turkey, Little told reporters flying with Panetta.

Turkey is a founding member of NATO and requested that the alliance provide Patriots. They will be sent by NATO members Germany and the Netherlands as well as the U.S. for an undetermined period.

During a brief stop at Incirlik Air Base, Panetta told U.S. troops that Turkey might need the Patriots, which are capable of shooting down shorter-range ballistic missiles as well as aircraft.

He said he approved the deployment "so that we can help Turkey have the kind of missile defense it may very well need to deal with the threats coming out of Syria," he said.

Panetta did not mention how soon the two Patriot batteries will head to Turkey or how long they might stay.

Incirlik is about 60 miles from the Syrian border.

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Tolkien class at Wis. university proves popular

MILWAUKEE (AP) — The vast collection of J.R.R. Tolkien manuscripts initially sold senior Joe Kirchoff on Marquette University, so when the school offered its first course devoted exclusively to the English author, Kirchoff wanted in. The only problem: It was full and he wasn't on the literature track.

Undaunted, the 22-year-old political science and history major lobbied the English department and others starting last spring and through the summer and "kind of just made myself a problem," he said. His persistence paid off.

"It's a fantastic course," said Kirchoff, a Chicago native. "It's a great way to look at something that's such a creative work of genius in such a way you really come to understand the man behind it."

He and the 31 other students can now boast of their authority about the author who influenced much of today's high fantasy writing. The course was taught for the first time this fall as part of the university's celebration of the 75th anniversary of "The Hobbit" being published. And class wrapped up just before the film, "The Hobbit: An Unexpected Journey," was released Friday.

The class, which filled up fast with mostly seniors who had first dibs, looked at Tolkien as a whole, not just the popular "Lord of the Rings" and "The Hobbit." Students took their final exam this week, and the course was so well received, Marquette is considering more in the future.

"It's the best class I've had in 27 years here ... for student preparation, interest and enthusiasm," said English professor Tim Machan. "And I can throw out any topic and they will have read the material and they want to talk about the material."

Marquette is one of the main repositories of Tolkien's drafts, drawings and other writings — more than 11,000 pages. It has the manuscripts for "The Lord of the Rings" and "The Hobbit," as well as his lesser-known "Farmer Giles of Ham" and his children's book "Mr. Bliss." Marquette was the first institution to ask Tolkien for the manuscripts in 1956 and paid him about $5,000. He died in 1973.

Other significant collections are at the Bodleian Library at Oxford University in England and Wheaton College in Illinois.

Though Tolkien classes aren't unusual nationwide, Marquette students had the added bonus of being able to visit Tolkien's revisions, notes, detailed calendars, maps and watercolors on site at the school's archive. And they got a lesson from the school's archivist Bill Fliss.

"One of the things we wanted to impress upon the students was the fact that Tolkien was a fanatical reviser," said Fliss said. "He never really did anything once and was finished with it."

Chrissy Wabiszewski, a senior English major, described Tolkien's manuscripts as art.

"When you get down and look at just his script and his artwork in general, it all kind of flows together in this really beautiful, like, cumulative form," Wabiszewski said. "It's cool. It is just really cool to have it here."

The class also looked at Tolkien's poetry, academic articles and translations of medieval poems; talked about the importance of his writers' group, the Inklings; and explored what it meant to be a writer at that time.

"We've ... tried to think about continuities that ran through everything he did," Machan said. His students were also required to go to three lectures that were part of Marquette's commemoration.

"The Hobbit," a tale of homebody Bilbo Baggins' journey, is set in Tolkien's fictional realm of Middle-earth and takes place 60 years before "The Lord of the Rings." The movie released Friday is the first of the trilogy, with "The Hobbit: There and Back Again" set for release on Dec. 13, 2013, and a third film to come out in the summer of 2014.

Most of the students were just finishing elementary school when the first "Lord of the Rings" film was released 11 years ago.

Kirchoff said he started reading "The Hobbit" and the "Lord of the Rings" when he was in fourth grade, before the movies came out. He said the movies have introduced others to Tolkien's ideas, making his love for Tolkien's fantasy worlds more socially acceptable.

"The movies were fantastic enough and engaging enough to coexist in my mind with the literature I really do love," he said.

Wabiszewski said it's clear her classmates weren't just taking the class as a filler.

"I definitely expected the enthusiasm from everybody but just the knowledge that everybody brought into the class, it's cool," she said. "We really have a smart group of people in that class who have a lot to offer."

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