N Korea marks first anniversary of late ruler's death






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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

- AFP/xq



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India pursuing Capt Kalia's case with Pakistan: Antony

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

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

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

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

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

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

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

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

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

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

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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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Conn. Shooter Adam Lanza: 'Obviously Not Well'













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


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


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


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


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


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


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


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


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








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


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


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


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


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


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


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


MORE: 27 Dead, Mostly Children, at Connecticut Elementary School Shooting


LIVE UPDATES: Newton, Conn. School Shooting


Click Here for the Blotter Homepage.



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Egyptians vote on divisive constitution


CAIRO/ALEXANDRIA (Reuters) - Egyptians voted on Saturday on a constitution promoted by its Islamist backers as the way out of a prolonged political crisis and rejected by opponents as a recipe for further divisions in the Arab world's biggest nation.


Queues formed outside polling stations in Cairo and other cities and soldiers joined police to secure the referendum process after deadly protests during the build up. Street brawls again erupted on Friday in Alexandria, Egypt's second city.


Mursi provoked angry demonstrations when he issued a decree last month expanding his powers and then fast-tracked the draft constitution through an assembly dominated by his Muslim Brotherhood group and its allies. At least eight people were killed in clashes last week outside the president's palace.


The liberal, secular and Christian opposition says the constitution is too Islamist and tramples on minority rights. Mursi's supporters say the charter is needed if progress is to be made towards democracy nearly two years after the fall of military-backed strongman Hosni Mubarak.


"The sheikhs told us to say 'yes' and I have read the constitution and I liked it," said Adel Imam, a 53-year-old queuing to vote in a Cairo suburb. "The president's authorities are less than before. He can't be a dictator."


Official results will not be announced until after a second round of voting next Saturday. But partial results and unofficial tallies are likely to emerge soon after the first round, giving an idea of the overall trend.


In Alexandria on Friday, tensions boiled over into a street brawl between rival factions armed with clubs, knives and swords. Several cars were set on fire and a Muslim preacher who had urged people to vote "yes" to the constitution was trapped inside his mosque by angry opposition supporters.


TRANSITION


Christians, making up about 10 percent of Egypt's 83 million people and who have long grumbled of discrimination, were among those queuing at a polling station in the port city to oppose the basic law. They fear Islamists, long repressed by Mubarak, will restrict social and other freedoms.


"I voted 'no' to the constitution out of patriotic duty. The constitution does not represent all Egyptians," said Michael Nour, a 45-year-old Christian school teacher in Alexandria.


Islamists are counting on their disciplined ranks of supporters and the many Egyptians who may fall into line in a desperate bid to end turmoil that has hammered the economy and sent Egypt's pound to eight-year lows against the dollar.


"I voted 'yes' for stability," said shopkeeper Ahmed Abou Rabu, 39. "I cannot say all the articles of the constitution are perfect but I am voting for a way forward. I don't want Egyptians to go in circles, for ever lost in this transition."


Mursi was among the early voters after polls opened at 8 a.m. (0600 GMT). He was shown on television casting his ballot shielded by a screen and then dipping his finger in ink - a measure to prevent people voting twice.


Polling stations close at 7 p.m. (1700 GMT), but the deadline could be extended depending on turnout.


After weeks of turbulence, there has been limited public campaigning. Disparate opposition politicians and parties, beaten in two elections since Mubarak's overthrow, only announced on Wednesday they backed a "no" vote over a boycott.


Flag-waving Islamists gathered peacefully at one of the main mosques on Friday, some shouting "Islam, Islam" and "We've come here to say 'yes' to the constitution".


PALACE SIT-IN


Opposition supporters assembled outside the presidential palace, where there has been a sit-in for days. The walls of the palace, ringed by tanks, are scrawled with anti-Mursi graffiti.


The referendum will be held on two days covering different regions, with the second round on December 22, because there are not enough judges willing to monitor all polling stations after some in the judiciary said they would boycott the vote.


Egyptians are being asked to accept or reject a constitution that must be in place before a parliamentary election can be held next year to replace an Islamist-led parliament dissolved this year. Many hope this will lead Egypt towards stability.


If the constitution is voted down, a new assembly will have to be formed to draft a revised version, a process that could take up to nine months.


Just over half of Egypt's electorate of 51 million will vote in the first round in Cairo and other cities.


To provide security for the vote, the army has deployed about 120,000 troops and 6,000 tanks and armored vehicles to protect polling stations and other government buildings


While the military backed Mubarak and his predecessors, it has not intervened on either side in the present crisis.


The charter has been criticized by some overseas bodies.


The International Council of Jurists, a Geneva-based human rights group, said it falls short of international standards on the accountability of the armed forces, the independence of the judiciary, and recognition of human rights.


United Nations human rights experts said the draft should be reviewed to ensure Egypt meets its obligations under international law on equality and women's rights.


(Writing by Edmund Blair and Giles Elgood; Editing by Andrew Heavens)



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Philippine police shoot dead Malaysian carrying bomb






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

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

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

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

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

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

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

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

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

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

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

- AFP/ck



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Kashmir valley remains cut-off from country for second day

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

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

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

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

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

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

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

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Study: People worldwide living longer, but sicker


LONDON (AP) — Nearly everywhere around the world, people are living longer and fewer children are dying. But increasingly, people are grappling with the diseases and disabilities of modern life, according to the most expansive global look so far at life expectancy and the biggest health threats.


The last comprehensive study was in 1990 and the top health problem then was the death of children under 5 — more than 10 million each year. Since then, campaigns to vaccinate kids against diseases like polio and measles have reduced the number of children dying to about 7 million.


Malnutrition was once the main health threat for children. Now, everywhere except Africa, they are much more likely to overeat than to starve.


With more children surviving, chronic illnesses and disabilities that strike later in life are taking a bigger toll, the research said. High blood pressure has become the leading health risk worldwide, followed by smoking and alcohol.


"The biggest contributor to the global health burden isn't premature (deaths), but chronic diseases, injuries, mental health conditions and all the bone and joint diseases," said one of the study leaders, Christopher Murray, director of the Institute of Health Metrics and Evaluation at the University of Washington.


In developed countries, such conditions now account for more than half of the health problems, fueled by an aging population. While life expectancy is climbing nearly everywhere, so too are the number of years people will live with things like vision or hearing loss and mental health issues like depression.


The research appears in seven papers published online Thursday by the journal Lancet. More than 480 researchers in 50 countries gathered data up to 2010 from surveys, censuses and past studies. They used statistical modeling to fill in the gaps for countries with little information. The series was mainly paid for by the Bill & Melinda Gates Foundation.


As in 1990, Japan topped the life expectancy list in 2010, with 79 for men and 86 for women. In the U.S. that year, life expectancy for men was 76 and for women, 81.


The research found wide variations in what's killing people around the world. Some of the most striking findings highlighted by the researchers: — Homicide is the No. 3 killer of men in Latin America; it ranks 20th worldwide. In the U.S., it is the 21st cause of death in men, and in Western Europe, 57th.


— While suicide ranks globally as the 21st leading killer, it is as high as the ninth top cause of death in women across Asia's "suicide belt," from India to China. Suicide ranks 14th in North America and 15th in Western Europe.


— In people aged 15-49, diabetes is a bigger killer in Africa than in Western Europe (8.8 deaths versus 1 death per 100,000).


— Central and Southeast Asia have the highest rates of fatal stroke in young adults at about 15 cases per 100,000 deaths. In North America, the rate is about 3 per 100,000.


Globally, heart disease and stroke remain the top killers. Reflecting an older population, lung cancer moved to the 5th cause of death globally, while other cancers including those of the liver, stomach and colon are also in the top 20. AIDS jumped from the 35th cause of death in 1990 to the sixth leading cause two decades later.


While chronic diseases are killing more people nearly everywhere, the overall trend is the opposite in Africa, where illnesses like AIDS, malaria and tuberculosis are still major threats. And experts warn again shifting too much of the focus away from those ailments.


"It's the nature of infectious disease epidemics that if you turn away from them, they will crop right back up," said Jennifer Cohn, a medical coordinator at Doctors Without Borders.


Still, she acknowledged the need to address the surge of other health problems across Africa. Cohn said the agency was considering ways to treat things like heart disease and diabetes. "The way we treat HIV could be a good model for chronic care," she said.


Others said more concrete information is needed before making any big changes to public health policies.


"We have to take this data with some grains of salt," said Sandy Cairncross, an epidemiologist at the London School of Hygiene and Tropical Medicine.


He said the information in some of the Lancet research was too thin and didn't fully consider all the relevant health risk factors.


"We're getting a better picture, but it's still incomplete," he said.


___


Online:


www.lancet.com


http://healthmetricsandevaluation.org


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Health-Exchange Deadline Looms













All of the Affordable Care Act, also known as "Obamacare," doesn't go into effect until 2014, but states are required to set up their own health care exchanges or leave it to the federal government to step in by next year. The deadline for the governors' decisions is Friday.


The health insurance exchanges are one of the key stipulations of the new health care law. They will offer consumers an Internet-based marketplace for purchasing private health insurance plans.


But the president's signature health care plan has become so fraught with politics that whether governors agreed to set up the exchanges has fallen mostly along party lines.


Such partisanship is largely symbolic because if a state opts not to set up the exchange, the Department of Health and Human Services will do it for them as part of the federal program. That would not likely be well-received by Republican governors, either, but the law forces each state's chief executive to make a decision one way or the other.


Here's what it looks like in all 50 states and the District of Columbia:



20 states that have opted out -- N.J., S.C., La., Wis., Ohio, Maine, Ala., Alaska, Ariz., Ga., Pa., Kan., Neb., N.H., N.D., Okla., S.D., Tenn., Texas and Wyo.






Charles Dharapak/AP Photo











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Several Republican governors have said they will not set up the exchanges, including Chris Christie (N.J.), Nikki Haley (S.C.), Bobby Jindal (La.), Scott Walker (Wis.), John Kasich (Ohio), Paul LePage (Maine), Robert Bentley (Ala.), Sean Parnell (Ark.), Jan Brewer (Ariz.), Nathan Deal (Ga.), Tom Corbett (Pa.), Sam Brownback (Kan.), Dave Heineman (Neb.), John Lynch (N.H.), Jack Dalrymple (N.D.), Mary Fallin (Okla.), Dennis Daugaard (S.D.), Bill Haslam (Tenn.), Rick Perry (Texas), and Matt Mead (Wyo.).


3 States Out, but a Little More Complicated -- Mont., Ind. and Mo.


The Montana outgoing and incoming governors are both Democrats, but the Republican state legislature rejected the Democratic state auditor's request to start setting up a state exchange. So a federal exchange will be set up in Montana as well.


The Indiana outgoing and incoming governors are both Republicans and outgoing Gov. Mitch Daniels deferred the decision to governor-elect and U.S. Rep. Mike Pence, who said his preference is not to set up a state health care exchange, paving the way for the feds to come in too.


In Missouri, Gov. Jay Nixon is a Democrat, but Prop E passed on Nov. 6, which barred his administration from creating a state-based exchange without a public vote or the approval of the state legislature. After the election, he sent a letter to the Department of Health and Human Services saying he would be unable to set up a state-based exchange, meaning the federal government would have to set up its own.


1 State Waiting for the White House -- Utah


Utah already has a state exchange set up, a Web-based tool where small-business employees can shop and compare health insurance with contributions from their employee. In a letter Republican Gov. Gary Herbert sent to the White House Tuesday, he asked for its exchange, called Avenue H, to be approved as a state-based exchange under the Affordable Care Act as long as state officials can open it to individuals and larger businesses.


Norm Thurston, the state's health reform implementation coordinator, says authorities there "haven't received an official response" from the White House, but "we anticipate getting one soon."


There are some sticking points that don't comply with the exchanges envisioned by the Affordable Care Act and Utah would like to keep it that way.






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U.S., rebels urge gloomy Moscow to help oust Assad


BEIRUT (Reuters) - Syria's rebel leadership and the United States seized on Russian pessimism over President Bashar al-Assad's future to urge Moscow to help push its ally into ceding power and end the battles closing in around his capital.


"We want to commend the Russian government for finally waking up to the reality and acknowledging that the regime's days are numbered," the U.S. State Department spokeswoman said after a senior Kremlin envoy conceded publicly on Thursday that Assad's opponents could win the 20-month-old civil war.


"The question now is, will the Russian government join those of us in the international community who are working with the opposition to try to have a smooth democratic transition?" U.S. spokeswoman Victoria Nuland added in Washington.


In Marrakech, where his new coalition won recognition from other international powers as the legitimate leadership of Syria, rebel political leader Mouaz al-Khatib said he believed Russia, ally and arms supplier to the Assad dynasty since Soviet times, was looking for ways out of its support for a lost cause.


"I believe that the Russians have woken up and are sensing that they have implicated themselves with this regime, but they don't know how to get out," al-Khatib told Reuters. He held them "particularly responsible" for helping Assad with arms but said Moscow need not "lose everything" in Syria if it changed tack.


Under President Vladimir Putin, wary since last year's Libyan war of what Russia sees as a Western drive to use the United Nations to overthrow national leaders it dislikes, Russia has blocked U.N. efforts to squeeze Assad, who has also had strong support from his long-time sponsor Iran.


But Mikhail Bogdanov, a deputy foreign minister and the Kremlin's special envoy for Middle East affairs, was quoted as saying in Moscow: "One must look the facts in the face."


"Unfortunately, the victory of the Syrian opposition cannot be ruled out." The Syrian government, he said, was "losing control of more and more territory" and Moscow was preparing to evacuate Russian citizens if necessary.


Nuland said Bogdanov's comments demonstrated that Moscow now "sees the writing on the wall" on Syria and said Russia should now rally behind U.N. efforts to prevent a wider bloodbath.


"They can withdraw any residual support for the Assad regime, whether it is material support (or) financial support," she said. "They can also help us to identify people who might be willing, inside of Syria, to work on a transitional structure."


DIPLOMACY


International envoy Lakhdar Brahimi, who has met Russian and U.S. officials twice in the past week, is seeking a solution based on an agreement reached in Geneva in June that called for the creation of a transitional government in Syria.


But Russia has repeated warnings that recognition of al-Khatib's coalition, notably by the United States, is undermining diplomacy, and rejected U.S. contentions that the Geneva agreement sent a clear message that Assad should step down.


Nuland said the Brahimi meetings could lay the framework for a political structure to follow Assad:


"We've said all along to the Russians that we are concerned that the longer that this goes on, and the longer it takes us to get to an alternative political path for Syria, the only path is going to be the military one and that is just going to bring more violence.


"We all ought to be working together."


Bogdanov, whose government has suggested that Assad himself should be allowed to see through a transition he has promised, suggested the rebels and their allies were set on a military solution and he gave little hint of detente with Washington.


"The fighting will become even more intense and (Syria) will lose tens of thousands and, perhaps, hundreds of thousands of civilians," Bogdanov was quoted as saying. "If such a price for the removal of the president seems acceptable to you, what can we do? We, of course, consider it absolutely unacceptable."


The head of NATO, Anders Fogh Rasmussen, said elsewhere: "I think the regime in Damascus is approaching collapse."


A U.S. official said: "Assad probably still believes that Syria is his and illusions can die hard. But Assad and those closest to him have got to be feeling the psychological strain of fighting a long war that is not going their way."


DAMASCUS BATTLES


But Al-Khatib, who played down Western concerns of sectarian Sunni Islamists in rebel ranks, warned that the fighting was far from over, even as it has begun to rattle the heart of Assad's power in Damascus. On Wednesday, a car bomb killed at least 16 people in a nearby town which is home to many military families.


"The noose is tightening around the regime," al-Khatib said.


"(But) the regime still has power. People think that the regime is finished, but it still has power left, but it is demoralized and however long it lasted its end is clear."


Day and night, Damascenes can hear the thunderous sound of bombardment aimed at rebel-held and contested neighborhoods.


The city's streets have now turned into a labyrinth of checkpoints and road blocks, with several major roads permanently closed off to traffic by concrete barriers.


"We escape from one place and trouble follows," said one grandmother, Um Hassan, as she described to Reuters her family's flight from one neighborhood to another as fighting seeps into the capital. "I don't know where we can keep running to."


Nonetheless, al-Khatib played down demands for their allies to provide heavier weaponry - a request long resisted by governments wary of anti-aircraft missiles and other hardware reaching Islamist rebels who might turn them against the West.


"The Syrian people ... no longer need international forces to protect them," he said, not specifying whether he meant a no-fly zone, arms supplies or other military support.


The opposition chief said he was willing to listen to proposals for Assad to escape with his life - "The best thing is that he steps down and stops drinking the blood of the Syrian people" - and outlined three scenarios for a change of power:


Al-Khatib ruled out the Russian proposal suggesting Assad hand over power to a transitional government while remaining president, saying it was "disgraceful for a slaughtered nation to accept to have a killer and criminal at its head".


The British-based Syrian Observatory said war planes bombed rebel-held eastern suburbs of Damascus on Thursday and artillery was hitting Daraya and Moadamiyeh, southwestern areas near the centre where rebels have been fighting for a foothold.


Syria has relied on war planes and helicopters to bombard rebel districts but Damascus denied accusations by U.S. and NATO officials that it had fired Scud missiles in recent days. The foreign ministry said the long-range missiles were not used against "terrorist groups," a term it uses for the rebels.


At least 40,000 people have been killed in Syria's uprising, which started in March 2011 with street protests which were met with gunfire by Assad's security forces, and which spiraled into the most enduring and destructive of the Arab revolts.


(Additional reporting by Steve Gutterman in Moscow and Andrew Quinn in Washington; Writing by Alastair Macdonald; Editing by Michael Roddy) For an interactive look at the uprising in Syria, please click on http://link.reuters.com/rut37s



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