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Washington is counting down the days of those large automatic across-the-board spending cuts. We were just hearing about the sequester that's set to go into effect March 1. That's this Friday. Some programs that benefit low-income Americans such as food stamps, Medicaid and welfare are exempt from those cuts. But many other programs are not. So service providers are scrambling to figure out how the budget stalemate will affect people who rely on government aid. Here's NPR's Pam Fessler.

PAM FESSLER, BYLINE: Hi, Kathy. How are you doing?

KATHY YOWELL: Pretty good.

FESSLER: Kathy Yowell was sitting in a wheelchair in the middle of her living room waiting for her daily delivery from Meals on Wheels of Takoma Park, Maryland. Today, she's getting fish, green beans and spinach along with a chicken sandwich, fruit, salad, juice and a bagel.

YOWELL: You want to just put that in the kitchen so you'll have a place to sit down?

UNIDENTIFIED WOMAN: Sure. I'd be glad to.

FESSLER: At age 82, Yowell says this service is a lifeline, especially after she had spinal surgery last August. Without the help...

YOWELL: I wouldn't be back in my house. I'd be in assisted living. And I don't think I would last very long in a place like that.

FESSLER: And that's the case for many of the millions of seniors served nationally by Meals on Wheels. Jill Feasley, who runs the Takoma Park program, says most of her clients are homebound and alone. They need food as well as someone to check in on them. But the Obama administration warns if automatic spending cuts go into effect this Friday, seniors could get four million fewer meals this year alone. Still, says Feasley...

JILL FEASLEY: We wouldn't feel the cuts immediately.

FESSLER: She says federal funds cover only about a quarter of her costs, so she has a little flexibility.

FEASLEY: I can dance a lot of dances. You know, I can try and raise more money from private donations. I can try and serve more hamburger.

FESSLER: Anything to avoid cutting actual meals. But Feasley does worry what the budget impasse will mean for her ability to raise funds in this Washington, D.C. suburb. Many of her donors are government workers facing furloughs.

ELLIE HOLLANDER: It's going to be devastating.

FESSLER: Ellie Hollander is president and CEO of the Meals on Wheels Association of America. She says many local programs are in a lot worse shape than Feasley's. They have long waiting lists and are already dealing with big cuts in state and local funding. She thinks as many as 19 million meals could be lost.

HOLLANDER: I can tell you, people are feeling it now. And a lot of that is just because of the uncertainty. And, you know, uncertainly leads to fear.

FESSLER: And fear is what many groups serving the poor are reporting. They say for everything from Head Start to low-income housing to child care subsidies, across-the-board spending cuts mean that hundreds of thousands of Americans will lose benefits they need to get by. But Republicans say these dire predictions are overblown, that they're really an effort to generate public pressure on them to raise taxes and avert what's known as the sequester. Michael Tanner is a senior fellow with the libertarian Cato Institute

MICHAEL TANNER: We're hearing that this is going to be massive, savage cuts. We're not even talking about actual cuts in spending. What we're talking about is reductions in the rate of growth of spending. You know, after the sequester is fully in place for 10 years, we will spend $2 trillion more than we're spending today.

FESSLER: Maybe so if you're looking at the entire budget, but the Reverend Douglas Greenaway of the National WIC Association says if the sequester occurs, cuts in nutrition for low-income women, infants and children will be real.

REVEREND DOUGLAS GREENAWAY: If I lose one mother off of this program, who is at nutrition risk, there's a real health consequence to her and to her unborn child. And the long-term consequence for this nation in reducing health care costs are significant because those contribute to the deficit.

FESSLER: So he argues if the goal is to reduce government spending overall, these cuts make no sense at all. Pam Fessler, NPR News, Washington.

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