The roughly $40 million that was set aside by the federal government to treat rescue workers, volunteers and firefighters who became ill after helping with the 9/11 cleanup and recovery will run out in months, physicians and federal officials said yesterday.

Members of Congress from New York and New Jersey secured $75 million a year ago to pay for health care expenses — including $40 million for treatments like drugs and medical procedures — for about 32,000 workers who reported ailments after working at ground zero. Distribution of the treatment money did not begin in earnest until October.

Officials at the two major monitoring and treatment programs, one run by Mount Sinai Medical Center and the other by the Fire Department, said yesterday that at the current spending rate, the treatment money would run out by spring or summer. They told top federal health officials that unless more financing was provided, they would be forced to notify thousands of patients that their treatment could soon end.

If all the workers needing treatment were to receive it, according to a new estimate by federal officials, the cost could exceed $250 million a year — a figure that may well meet with resistance from lawmakers in Washington, who are facing intense budget pressures. Several Democratic legislators have said they will make 9/11 health a priority when their party takes control of Congress next month.

The two-page federal estimate, which projects total annual costs of $256.6 million, was provided to The New York Times by an official involved in talks over how to pay for the care. It includes $163.6 million in direct medical expenses for 19,200 patients: $91.2 million for 9,600 patients with respiratory or digestive disorders, $58 million for 8,000 patients with 9/11-related mental illnesses and $14.4 million for 1,600 patients with musculoskeletal conditions. Medications account for more than half of the treatment cost.

About 32,000 people are registered in the two treatment programs. Some are only monitored periodically, but even the monitoring (including exams) will cost $30 million a year, according to the estimate. The estimate also anticipates that hospitalization costs will start at $8 million a year and “will increase significantly over time.”

It anticipates $49.1 million a year in administrative costs, $6 million for translation services and an as-yet-undetermined figure for “emerging issues” like complicated orthopedic diseases and disorders that may not become evident for many years, including certain lung and autoimmune diseases and cancers.

Senator Hillary Rodham Clinton and others have long argued that the federal commitment to aiding 9/11 workers was too little and too late. Yesterday morning, Mrs. Clinton, three House members from New York City and labor representatives and medical experts met with federal health officials at Hunter College in Manhattan.

Mrs. Clinton said the new Congress faces “a lot of tough choices.” She added: “I am not going to say where the money should come from, I’m merely saying that this should be a national priority. It is not just a New York priority.”

Dr. John O. Agwunobi, the assistant secretary for health at the Department of Health and Human Services, made no commitments other than promising to convey the urgency of the matter to Michael O. Leavitt, the department’s secretary, according to several participants in the meeting, which was not open to the public.

Dr. Agwunobi and Dr. John Howard, the director of the National Institute for Occupational Safety and Health, which prepared the estimate, are co-chairmen of a task force appointed by Mr. Leavitt to examine 9/11 health issues.

Holly Babin, a spokeswoman for the Department of Health and Human Services, said yesterday that she was not familiar with the estimate and that several approaches were being considered. “The task force is to come up with a number of different options and models,” she wrote in an e-mail message, adding that it was looking at a variety of approaches and preparing cost estimates for each.

“This work is ongoing, and therefore it is premature to speculate on cost for any or all, particularly since we do not know what option the secretary will choose,” Ms. Babin wrote.

At the meeting, Dr. Agwunobi said the task force might not complete its analysis until February or March, and New York officials responded that that would be too late to affect President Bush’s budget presentation, according to Representative Jerrold L. Nadler, who attended the meeting with two other House members, Vito J. Fossella and Carolyn B. Maloney.

In an interview, Dr. Agwunobi, who heard personal accounts from two men — Marvin E. Bethea, a paramedic, and Jonathan F. Sferazo, a structural-iron worker — who founded Unsung Heroes Helping Heroes, a support group for rescue workers, described the meeting as “very honest.”

“This was actually a very humbling experience,” he said. “It was an opportunity for me to put the voices with all the data that we see in Washington, to put a face to the victims.” After the meeting, Dr. Agwunobi visited the two treatment program centers.

Other participants left the meeting frustrated. “We had two questions for Dr. Agwunobi: Will you put it in the president’s budget and what is your plan?” said Micki Siegel de Hernández, a district health and safety director for the Communications Workers of America. “He skirted around the issue and did not answer.”

Dr. Howard, who in February was named the federal coordinator for 9/11 health efforts, expressed sympathy for the local officials. He said of Dr. Agwunobi, “We hope that we’re able to fill his mind with all the good works that we’re doing here and the need that people have in New York.”