(The Medicare trustees say it will cost $8 trillion.)

If the Medicare trustees make this determination in two consecutive years, a "funding warning" is issued.

In 2009, for the fourth consecutive year, the Medicare trustees determined that general fund revenue would exceed the threshold.

The report by the Medicare trustees underlines a problem facing the Administration.

The Medicare trustees said that by 2019 - seven years sooner than was expected last year - the hospital insurance trust fund is projected to exhaust its surplus.

Mr. Hayes said the lost ground in the Medicare trustees' projections this year reflected a weak economy as well as rising health care costs.

But Marilyn Moon, an economist and former Medicare trustee, said she had little confidence in such long-range projections.

Early next year, the Medicare trustees will issue their annual report on the financial health of the program.

Dr. Shalala is one of six Medicare trustees.

For several years, the Medicare trustees have assumed that average health costs for each beneficiary will grow, after 2025, at the same rate as the gross domestic product.