HCR Update from Mark Sanna: President Barack Obama today released a proposed $3.8 trillion budget for fiscal 2014 that would shrink the federal deficit by $1.8 trillion over the course of 10 years, but not on the backs of physicians. Instead, they are on the receiving end of some federal largesse. For starters, Obama's deficit reduction would replace the automatic, across-the-board cuts called sequestration that include a 2% decrease in Medicare reimbursement for physicians.