The federal government has announced close to 192,000 low-income Medicare beneficiaries face a sharp increase in medical costs because Congress has not renewed a program that pays their monthly premiums. The program, known as the Q.I. program, paid the $78 dollar monthly fee for low-income beneficiaries up until it expired at the end of September. Adding to the burden, the cost of the basic Medicare premium will rise to $88 a month in January. The Bush administration has proposed a one-year extension to the program. Both houses of Congress have passed bills to reinstate it, but final legislation has been held up due to differences on other issues included in the bill.