Substantial Medicare cuts will be on the table after the White House budget is released Wednesday, administration officials have indicated.

The proposed budget is expected to include about $400 billion in Medicare savings over 10 years, reflecting an offer President Barack Obama extended to Speaker of the House John Boehner (R-OH) in December, prior to the fiscal cliff deal.

Some see the Medicare cuts as a concession to pave the way for a budget deal with the GOP, as the White House seeks a middle ground between the starkly different proposals put forward in Congress by Rep. Paul Ryan (R-WI) and Sen. Patty Murray (D-WA). However, Boehner called the expected Medicare cuts “modest entitlement savings” that would not justify anticipated tax hikes in Obama’s budget, The New York Times reported.

Obama also faces pressure from the left, as groups have been quick to criticize the Medicare cuts and a likely proposal to change the way inflation is calculated for Social Security payments. Senior advocacy organizations say seniors would be hurt not only by shrinking Medicare, but by the inflation measurement that does not account for the true rise in costs of healthcare.