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Even though Congress has agreed — for now — not to slash Social Security or Medicare in its plan to curtail federal spending, people reliant on the programs for their basic well-being aren't necessarily worrying less.

The fear and anxiety Congress caused for people like Tooele resident Pat DeSilva, 69, who has chronic lung disease, constant pain from a ruptured disc and high blood pressure, will take time to ebb.

"It definitely scared me," said DeSilva, a retired nurse whose Social Security payments represent 90 percent of her personal income. "All of us have got to say to the people in Washington, 'What am I supposed to do if my Medicare and Social Security is cut?' I wish they understood more what this puts us through."

It's a question that county officials, especially in rural Utah, also ask, because in bad times the money that Social Security recipients put into the economy is considered solid as bedrock.

Scott Hirschi, Washington County's economic development director, said that 10 to 15 years ago, the consensus there was that retired people didn't do much for the economy. But he never agreed.

"The stability that Social Security and other income earnings that those in the retirement age bracket bring to the county is immensely important," said Hirschi. "I'm not sure that can be overrated."

In a county-by-county analysis of 2010 data, AARP Utah found that statewide, 312,029 Utahns rely on Social Security — including 28,000 children — and pump $351 million into the economy. According to 2007 data, Medicare provides basic health care for 277,783 state residents.

Of the state's 29 counties, the 11 that comprise the Five County and Six County associations of government are in the top 15 most dependent on Social Security.

Ken Sizemore, director of the Five County Association of Governments, said in the group's most recent newsletter that aging service needs, especially health programs aimed at keeping elders out of nursing homes, continue to grow even as budgets have been cut. The five counties are Kane, Washington, Garfield, Beaver and Iron.

Scott Christensen, the Six County Area Agency on Aging director, said he's been working with older adults for 10 years and has seen their personal income situations deteriorate. There was a time, he said, when people who turned 65 had more savings. Not now, though.

"They've had to spend it to live on," he said.

The six counties are Piute, Sanpete, Wayne, Sevier, Millard and Juab.

In Piute County, where nearly 30 percent of residents receive Social Security, the rate of home ownership is the highest in the state. That means people can't, or won't, move closer to services. That stresses his agency's ability to serve them, as the Six County region is so spread out and its budget keeps getting cut.

Christensen said he's seen three generations cramming into a single home. "You've got everyone living on the father or grandfather's monthly income," he said. People have to travel long distances for groceries or medical services, and the cost of gas has become crippling.

DeSilva said that she lived in motor homes or travel trailers for 12 years before she finally accepted she needed better shelter. She found an apartment with a federal rent subsidy, but her housing expenses still went up.

She ticks off her resources and her costs: From Social Security and a small annuity, she nets up to $1,450 after paying her Medicare premiums. Rent costs $493 per month; medical services, $400. With what's left she buys food, gasoline, shoes, clothes and everything else she needs.

The debt-ceiling debate, DeSilva said, was a power struggle between people trying to make names for themselves. "It was terrible to me," she said. "We're sitting down here on the bottom, and we're thinking, 'My God.' "

AARP, roundly criticized for announcing early in the debate that changes to Social Security and Medicare might be part of the package, has defended itself and maintains it never supported any cuts of any kind as part of the debt-ceiling deal.

"Cutting services to the most vulnerable population groups in the state is not the way to see long-term fiscal security in this country," Alan Ormsby, the organization's Utah director, said in a statement.

Christensen said that while he agrees federal spending has to slow, he's afraid scare tactics will continue to the detriment of seniors. "These changes in Washington, if they don't come to agreement, it's going to hurt," he said. "We've got to get this under control."

Twitter: @sltribhenetz

Tony Semerad contributed to this story. —

Southern Utah counties need Social Security to survive

AARP Utah has released figures that show the percentage of county residents who receive Social Security, with 13 of the 15 most dependent counties in the south.

Piute • 29.9 percent

Daggett • 23.5 percent

Kane • 25.5 percent

Washington • 19.8 percent

Sanpete • 16.9 percent

Garfield • 21.6 percent

Emery • 18.3 percent

Wayne • 20.9 percent

Sevier • 19.8 percent

Carbon • 21.5 percent

Beaver • 17.6 percent

Millard • 18.3 percent

Iron • 14.4 percent

Grand • 17.5 percent

Juab • 14.5 percent