President Obama's plan to expand health coverage is likely to dig the nation deeper into debt unless policymakers adopt controls on spending, such as sharp reductions in payments to doctors, hospitals, and other providers, congressional budget analysts said. The pronouncement from the Congressional Budget Office is likely to complicate the task of enacting comprehensive changes this year. Democratic lawmakers will lose support unless they produce a package that has the potential to lower the nation's debt. But hospitals and drugmakers already are balking at proposals that would cut their federal payments.