WASHINGTON — President Obama’s effort to control federal spending would require the largest cuts from the government’s biggest programs — health care and the military — while preserving or increasing spending on favored initiatives like early education, manufacturing and research.

The president’s proposed budget, for the fiscal year beginning Oct. 1, will be extensively rewritten in Congress, but is designed to reduce the growth of federal health spending by $401 billion over 10 years.

The budget would require $57 billion in higher payments by Medicare beneficiaries, cut $306 billion in projected Medicare payments to health care providers and squeeze $19 billion out of Medicaid, the program for low-income people.

Kathleen Sebelius, the secretary of health and human services, said Wednesday that the president was requesting $1.5 billion to operate health insurance supermarkets, known as exchanges, in 2014. In addition, the administration plans to raise $450 million by charging insurance companies fees to sell their products to consumers and small businesses in the exchanges. The federal government will have the primary responsibility for operating the exchanges in more than 30 states.