By Mary Agnes Carey Kaiser Health News

Doctors serving Medicare patients. Scientists looking for a better way to treat diabetes. HIV patients who can't afford to buy their medications. These are but some of the many people who will be affected by the automatic federal spending cuts that officially took effect Friday.

Both Democrats and Republicans say they didn't like the budget reductions, called the sequester, but they couldnt agree on how to stop them. The $85.3 billion in cuts for fiscal 2013, which ends Oct. 1, are part of a larger package of $1.2 trillion in trims scheduled to occur over the next decade. The reductions are split evenly between defense and domestic programs.

The sequester would not affect Medicaid, the joint federal-state health program for the poor. However, Medicare spending would be cut by 2 percent through reductions in payments to hospitals, physicians and other care providers, including Medicare Advantage plans and the companies running the Medicare Part D plans. By law, the Medicare cuts dont begin until April 1.

But other health care efforts would be among the government programs that face reductions of about 9 percent, according to the Office of Management and Budget. The full impact likely won't be felt for weeks as the cuts roll out, and some lawmakers have suggested that sequestration cuts could be dealt with as part of negotiations to fund the government after the current continuing resolution expires March 27.

Dr. Gary Wiltz, the chairman-elect of the board of the National Association of Community Health Centers, one of the groups facing those cuts, said the reduced federal funding will cause the centers to dramatically curtail services and estimates that as many as 900,000 patients could be turned away from care. "Many of them cannot afford to go anyplace else," he said in a statement.

President Barack Obama Tuesday called on Congress to work out a different scenario for dealing with the nations fiscal problems and avert the "painful, arbitrary budget cuts." Addressing workers at a shipbuilding facility in Newport News, Va., he said, "Instead of cutting out the government spending we don't need -- wasteful programs that don't work, special interest tax loopholes and tax breaks -- what the sequester does is it uses a meat cleaver approach to gut critical investments in things like education and national security and lifesaving medical research." He is urging a combination of spending cuts and additional federal revenues through changes in the tax code.

But Republicans are opposed to any increase in taxes to fund the spending. Senate Minority Leader Mitch McConnell, R-Ky., criticized the president Thursday for failing to offer "a serious plan."

"Instead of directing his cabinet secretaries to trim waste in their departments, he's going to go after first responders. And teachers," McConnell said. "And almost any other sympathetic constituency you can think of. Hell say he has no choice but to release criminals into the streets and withhold vaccines from poor children. And somehow, it will be everyones fault but his. Nonsense."

The president and congressional leaders are meeting at the White House today on the issue.

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NATION: How the sequester affects health care