A second budget-cutting installment will come later in the year. A special congressional committee will be appointed, with 12 members drawn in equal numbers from the House and Senate, Republicans and Democrats. They are charged with proposing $1.2 trillion to $1.5 trillion in further cuts.

Republicans, throughout the deficit battle, have resisted increases in taxes, while congressional Democrats have fought cuts to Social Security and Medicare beneficiaries. Those ideas could be included in the second round of cuts — but only if the committee can get past those entrenched divisions.

Obama on Sunday said no one got everything they wanted out of the deal, including him.

"Despite what some Republicans have argued, I believe that we have to ask the wealthiest Americans and biggest corporations to pay their fair share by giving up tax breaks and special deductions. Despite what some in my own party have argued, I believe that we need to make some modest adjustments to programs like Medicare to ensure that they're still around for future generations."

Once the special committee draws up its package of deficit reductions, Congress will vote on the entire package in December without being able to amend it. If nothing passes, automatic spending cuts of $1.2 trillion will kick in. Half the dollars will come from defense and security spending and the other half from other domestic programs.

Social Security and Medicare cuts could come later

The automatic cuts don't affect Social Security, Medicaid, taxes or veterans benefits. But they would cut Medicare payments to medical providers. Seniors would not see a change in their benefits. But, Certner says, cuts to medical providers could mean seniors have a harder time finding a doctor willing to accept Medicare.

"The deeper you cut payments to providers, the more you create disincentives to treating people on Medicare," he says.

White House press secretary Jay Carney says those cuts are capped. But the prospect of cuts to Medicare and other programs is designed to motivate lawmakers to compromise on their own package of deficit reductions instead of relying on the automatic cuts.

"This is tough stuff," Carney said Monday. "It's supposed to be tough stuff … so Congress doesn't go there."

Congress already is facing a conundrum of cuts to Medicare doctors. Huge cuts in reimbursement rates for doctors are scheduled to go into effect at the end of the year from past legislation. Each time this has happened before, Congress has given the doctor payments a reprieve instead of cutting the rates. But finding money to keep the rates stable could be difficult as Congress makes large budget cuts. "You have crosswinds," Certner says.

"Sometime we are going to have to realize the fundamental problem in Medicare is not that we are overpaying providers," says Foster.

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