Wondering what your Medicare pay will look like in 2010? Congress just passed a $3.4 trillion federal budget for fiscal year 2010, and healthcare was a key focus -- but a controversial one at that. The House passed the budget by a 233-193 vote on the morning of April 2, followed by the Senate with a vote of 53-43 just hours later. It honors the three pillars of the Obama initiatives: energy, healthcare, and education, cheered House Speaker Nancy Pelosi (D-Calif.) in the Washington Post. Republicans, however, were not happy with the budget, and none of them voted in favor of it. The budget plan skirts difficult decisions on how to pay for Obamas health care plan, which is expected to cost more than $1 trillion over the next decade, according to the Post. Medicare physicians payment would not be offset for two years, according to the April 28 CongressDaily. Déjà vu: You may not see a long-term physician pay fix just yet. While the budget resolution takes important steps in the near-term of cutting the deficit & it is clear that more will be needed to address the long-term fiscal imbalance confronting the nation beyond the five-year budget window, said Senate Budget Chairman Kent Conrad (D-N.D.). At the same time, this budget is a major accomplishment, Conrad acknowledged.