HCR Update from Mark Sanna: President Obama faces two major challenges when he unveils his health budget today: showing that he's serious about fiscal discipline while making sure implementation of his health care reform law has a clear path. His health budget will receive extra scrutiny this year given that his fiscal commission called health care spending the nation's "single largest fiscal challenge" and Republicans are angling to defund the law. But Obama's budget likely won't provide too many surprises because the reform law has already done a lot of the heavy lifting on spending cuts, lobbyist sources said on Friday. The Affordable Care Act slows the growth of Medicare spending by about $500 billion over 10 years.