WASHINGTON — Democrats in Congress are curbing their ambitions for President Biden’s economic agenda, and Jennifer Mount, a home health care aide, worries that means she will not get the raise she needs to pay more than $3,000 in medical bills for blindness in one eye.

Edison Suasnavas, who came to the United States from Ecuador as a child, has grown anxious about the administration’s efforts to establish a pathway to citizenship, which he hoped would allow him to keep doing molecular tests for cancer patients in Utah without fear of deportation.

And Amy Stelly wonders — thanks to a winnowing of Mr. Biden’s plans to invest in neighborhoods harmed by previous infrastructure projects like highways that have harmed communities of color — whether she will continue to breathe fumes from a freeway that she says constantly make her home in New Orleans shudder. She has a message for the president and the Democrats who are in the process of trying to pack his sprawling agenda into a diminishing legislative package.

“You come up and live next to this,” Ms. Stelly said. “You live this quality of life. We suffer while you debate.”

Mr. Biden began his presidency with an expensive and wide-ranging agenda to remake the U.S. economy. But under the duress of negotiations and Senate rules, he has shelved a series of his most ambitious proposals, some of them indefinitely.

He has been thwarted in his efforts to raise the federal minimum wage and create a pathway to citizenship for undocumented immigrants. He has pared back investments in lead pipe removal and other efforts that would help communities of color. Now, as the president tries to secure votes from moderates in his party, he is reducing what was originally a $3.5 trillion collection of tax cuts and spending programs to what could be a package of $2 trillion or less.

That is still an enormous spending package, one that Mr. Biden argues could shift the landscape of the economy. But a wide range of Americans who have put their faith in his promises to reshape their jobs and lives are left to hope that the programs they are banking on will survive the cut; otherwise, they face the prospect of waiting years or perhaps decades for another window of opportunity in Washington.

“The problem now is this may be the last train leaving the station for a long time,” said Jason Furman, an economist at the Harvard Kennedy School who was a top economic adviser to President Barack Obama. “It could be five, 10, 20 years before there’s another shot at a lot of these issues.”

Mr. Furman and other former Obama administration officials saw firsthand how quickly a presidential agenda can shrink, and how presidential and congressional decisions can leave campaign priorities unaddressed for years. Mr. Obama prioritized an economic stimulus package and the creation of the Affordable Care Act over sweeping immigration and climate legislation in the early years of his presidency.

Stimulus and health care passed. The other two did not.

A similar fate now could befall Mr. Biden’s plans for home care workers, paid leave, child care subsidies, free prekindergarten and community college, investments in racial equity and, once again, immigration and climate change.

If Mr. Biden is able to push through a compromise bill with major investments in emissions reduction, “he’s got an engine that he’s working with” to fight climate change, said John Podesta, a former top aide to Mr. Obama and President Bill Clinton. “If he can’t get it, then I think, you know, we’re really kind of in soup, facing a major crisis.”

Republicans have criticized the spending and the tax increases that would help fund it, claiming that the Democratic package would hurt the economy. Democrats “just have an insatiable appetite to raise taxes and spend more money,” Representative Steve Scalise, Republican of Louisiana, said on “Fox News Sunday” this week. “It would kill jobs.”

The threat of Republican filibusters has blocked Mr. Biden’s plans for gun and voting-rights legislation.

For now, though, the president’s biggest problem is his own party. He is negotiating with progressives and moderates over the size of the larger tax and spending package. Centrists like Senators Joe Manchin III of West Virginia and Kyrsten Sinema of Arizona have pushed for the price tag to fall below $2 trillion. Mr. Manchin has said he wants to limit the availability of some programs to lower- and middle-income earners. Progressive groups are jockeying to ensure that their preferred plans are not cut entirely from the bill.

The House has proposed investing $190 billion in home health care, for example, less than half of what Mr. Biden initially asked for. If the price tag continues to decrease, Democrats would almost certainly have to choose between two concurrent aims: expanding access to older Americans in need of caretakers or raising the wages of those workers, a group that is disproportionately women of color.

Another proposal included in Mr. Biden’s original infrastructure bill was an investment of $20 billion to address infrastructure that has splintered communities of color, although the funding was slashed to $1 billion through a compromise with Republican senators.

Ms. Stelly thought the funds, plus the president’s sweeping proposals to address climate change — which might also be narrowed to appease centrist Democrats — would finally result in elected officials addressing the highway emissions that have filled her lungs and darkened the windows of her home.

Ms. Stelly, an urban designer, has since limited her expectations. She said she hoped the funding would be enough to at least issue another study of the highway, which claimed dozens of Black-owned businesses and the once-thriving neighborhood of Tremé.

Some Democrats are eager to pack as much as they can into the bill because they fear losing the House, the Senate or both in the midterm elections next year. Mr. Podesta has urged lawmakers to see the package as a chance to avoid those losses by giving Democratic incumbents a batch of popular programs to run on, and also giving the president policy victories that could define his legacy.

Mr. Biden has promoted some of his policies as ways to reverse racial disparities in the economy and lift families that are struggling in the coronavirus pandemic from poverty.

Ms. Mount, who immigrated to the United States from Trinidad and Tobago, said she was appreciative of her job helping older Americans and the disabled eat and bathe and assisting them in their homes. But her wages for her long hours — working about 50 hours a week for $400, at times — have made it effectively impossible to stay on top of payments for basic needs.

She had hoped Mr. Biden’s plan to raise the minimum wage or salaries for home health care aides meant she would no longer need to choose between her electric bills and her medical expenses. She said the treatment had improved her blindness, but without a salary increase for her field, she is more convinced that she will be working for the rest of her life.

“I have to make a choice: Do I go to the grocery store or pay my mortgage? Do I pay my water bill or pay my electric bill?” said Ms. Mount, who lives in Philadelphia. “With that, retirement looks B-L-E-A-K, all uppercase. What do I have there for retirement?”

When Mr. Biden initially proposed two years of free community college, Ms. Mount, 64, was encouraged about future opportunities for her six grandchildren in the United States. But she fears that effort could also be cut.

“That’s politics from on top,” she said. “At times, they always seem detached.”

Some measures that Democrats have long promised voters have run afoul of Senate rules that dictate which policies the administration should include in bills that use a special process to bypass the filibuster, including a minimum-wage increase and a plan to offer citizenship to immigrants brought to the United States as children.

When the Senate parliamentarian rejected the strategy, it made Mr. Suasnavas, who has lived in the United States since he was 13, consider the prospect of eventually being deported; he would have to leave behind his job as a medical technology specialist, and his 6-year-old daughter and 2-year-old son.

“We’ve been having the hopes that politicians in Washington — Democrats and Republicans — will see not only the economic impact we can bring to the country but also we’re still people with families,” said Mr. Suasnavas, 35. “Our hearts have been broken so many times that it feels like another wound in your skin.”