The success of Obamacare--and the White House's efforts to drive down health care spending--depend on the cooperation of the doctors and hospitals charged with carrying out reforms.

Keeping those parties happy, however, isn't easy when health care providers lose billions of dollars each year as Congress looks for ways to trim the budget.

It's a mixed message, says Chip Kahn, the president and CEO of industry lobby group Federation of American Hospitals, to say that hospitals are saving money and still facing cuts.

"There's already been so much taken from hospitals," Kahn said. "It'd be hard to feel good about the progress underway because of the Affordable Care Act. The mechanisms are in place now to provide incentives to improve care. I do think from a standpoint of access to care and providing us the funds we need for reform--because reform costs money--there will be a point at which the camel's back breaks if Congress chooses to cut hospitals."

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