Democrats risk cutting health care and subsidies if they pass an aid plan without Republican support.

By Sahil Kapur- NBC News

WASHINGTON - Democrats, who are considering a move to renounce bipartisan support (that is, move forward without Republicans) and

pass the pandemic aid package

, face an unintended consequence: They may end up automatically cutting the care program. medical Medicare.

Many Democrats want to pass President Joe Biden's $ 1.9 trillion COVID-19 relief proposal,

which includes $ 1,400 stimulus checks

and aid to local governments.

A group of Republican senators is pushing for a smaller plan that would include checks for $ 1,000.

[Biden meets with Republican senators proposing a check for $ 1,000 - no deal yet]

As a result, Democratic leaders are preparing to use a process known as

budget reconciliation

, which would allow them to pass Biden's proposal without having to get 60 votes in the Senate, which requires at least 10 Republicans.

But under the Pay-As-You-Go Act of 2010, known as PAYGO,

new laws that increase the national debt automatically cause compensatory cuts in some safety net programs.

The cuts can only be avoided with 60 votes in the Senate, according to experts, which leaves Democrats back to square one, as it is not clear that Republicans will vote to avoid the cuts after having opposed a package. of partisan aid.

 President Joe Biden meets with Sen. Susan Collins, R-Maine, to discuss a coronavirus relief package in the Oval Office of the White House, Monday, February 1, 2021, in Washington DC.

AP / Evan Vucci

"It's Medicare. It's farm subsidies," said Marc Goldwein, a budget expert with the Committee for a Responsible Federal Budget, who is not partisan.

"A lot of programs would be cut," he

warned.

The magnitude of the reductions in Medicare and other social safety net programs would depend on the size of the package, but they would be significant even if the price was less than a trillion dollars.

Social Security and low-income programs would be exempt.

[Biden agrees to negotiate with Republican senators a check plan only for families “who need it most”]

"The cuts would be huge,"

said Paul Van de Water, a fellow at the Center for Budget and Policy Priorities, a liberal think tank.

"It is a critical issue that, at some point, is going to have to be addressed," he said. 

The chairman of the Senate Budget Committee, Senator

Bernie Sanders

from Vermont

,

who will lead the reconciliation process and has been a supporter of expanding welfare programs, will work to avoid cuts, according to his spokesman, Keane Bhatt.

Mitch McConnell Publicly Condemns the Lies of Republican Congresswoman Marjorie Taylor Greene

Feb. 2, 202100: 26

Bhatt noted that the last time budget reconciliation was used to make a big change was when Republicans passed a costly tax cut in a partisan vote, which triggered $ 25 billion cuts in Medicare.

But Democrats joined Republicans in preventing the cutback from taking effect in a government funding measure that was subsequently passed.

[Alexandria Ocasio-Cortez says she was a victim of "sexual assault" while recalling the threats she received during the assault on the Capitol]

"Trump and his Republican colleagues used deficit spending to pass $ 2 trillion in tax breaks, which overwhelmingly benefit the wealthiest and large corporations, and expand a military budget with a Pentagon that has never been independently audited," Bhatt said.

"When it comes to feeding hungry children or treating sick people in the midst of a pandemic,

funding cuts due to alleged deficit concerns would be unacceptable and immoral,

" he added.

There may be other ways to stop the cuts, but they would be difficult in practice, according to Van de Water.

Sen. Bernie Sanders, D-Vermont, questions former Gov. Jennifer Granholm, D-Michigan, as she testifies before the Senate Energy and Natural Resources Committee during a hearing to examine her nomination as Secretary of Energy, Wednesday, Jan. 27, 2021 at the Capitol in Washington.

AP

Congress could declare the bill an emergency measure, exempting it from PAYGO, but adding that provision would likely require 60 votes.

Lawmakers could try to use a future reconciliation bill to disable automatic cuts, but this would create a cascading effect that would involve borrowing from the future, Van de Water said.

The

Congress would have until the

end of 2021 to avoid cuts,

and could do so at any bill in the framework of the regular process, said Bill Dauster, who was political adviser when Harry Reid, of Nevada, was the Democratic leader of the Senate.

[Biden orders Obamacare enrollment reopened and Medicaid strengthened]

"All of God's children should want to avoid an attack on Medicare and other rights," he said.

"There are reasonable incentives to want to avoid it again this year," he added.

House Speaker Nancy Pelosi and Senate Majority Leader Chuck Schumer introduced a budget measure Monday that

would set the stage for using reconciliation

, which

does not preclude a bipartisan package.

[Democrats prepare to push pandemic aid package without Republicans]

"

The only thing we cannot accept is a package that is too small

or too narrow to get our country out of this emergency," Schumer said.

"We cannot repeat the mistake of 2009," he added.

On the other hand, Democrats could overturn automatic cuts if they raise taxes to avoid increasing debt or if they abolish the mechanism of filibusterism (filibuster, in English), a political procedure used in the Senate to block laws or unwanted nominations by part of those who constitute the minority.

Goldwein said that forcing Congress to worry about debt was the purpose of the 2010 law.

"It's supposed to be an obstacle," he said.

"The objective of the PAYGO law is to encourage political leaders to pay for things so that the debt does not get worse," he concluded.