A nutrition specialist prepares a Meals on Wheels delivery in upstate New York. The national organization says the sequester could mean significant cuts in the number of meals they serve to homebound seniors.

Those who serve low- and middle-income people warn that cuts required by the looming sequester will hurt programs that many Americans rely on, like meals for seniors, heating assistance and nutritional aid for expectant mothers. But supporters of the sequester say those fears are overblown.

Many programs affecting low-income Americans — like food stamps, Medicaid and Temporary Assistance for Needy Families — are exempt from across-the-board spending cuts set to go into effect March 1.

But many other programs are not, and that has service providers scrambling to figure out how the budget stalemate in Washington might affect those who rely on government aid.

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

Yowell, 82, says the service is a lifeline, especially after she had spinal surgery last August. Without the help, she says, "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."

That's the case for many of the millions of seniors who are served by Meals on Wheels nationwide. Jill Feasley, who runs the Takoma Park program, says most of her clients are homebound and alone. They need both food and someone to check in on them.

But if automatic spending cuts go into effect this Friday, the Obama administration warns, seniors could get 4 million fewer meals this year alone.

Still, Feasley says her program "wouldn't feel the cuts immediately." Federal funds cover only about one-quarter of her costs, she says, so she has a little flexibility.

"I can dance a lot of dances," Feasley says. "I can try and raise more money from private donations. I can try and serve more hamburger." Anything, she says, to avoid cutting actual meals.

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 and are facing potential furloughs if the sequester kicks in.

Fear And Uncertainty

Ellie Hollander, president and CEO of the Meals on Wheels Association of America, says the sequester would be "devastating."

Many local programs are in a lot worse shape than Feasley's, she says. They have long waiting lists and are already dealing with big cuts in state and local funding. Hollander thinks as many as 19 million meals could be lost.

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

And fear is what many groups serving the poor are reporting. For everything from Head Start and low-income housing to child care subsidies, advocates say across-the-board spending cuts mean that hundreds of thousands of Americans will lose benefits they need to get by.

But Republicans and others say these dire predictions are overblown and that they're really an effort to generate public pressure on them to raise taxes and avert the sequester.

Cutting, Or Slowing, Growth?

"We're hearing that this is going to be massive, savage cuts," says Michael Tanner, a senior fellow with the libertarian Cato Institute. "We're not even talking about actual cuts in spending. What we're talking about is reductions in the rate of growth of spending. After the sequester is fully in place for 10 years, we will spend $2 trillion more than we're spending today."

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

"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," Greenaway says. "And the long-term consequence for this nation in reducing health care costs are significant because those contribute to the deficit."

So, he says, if the goal is to reduce government spending overall, these cuts make no sense at all.

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