Montgomery County residents are bracing for a crush of traffic after hundreds of millions of dollars slated to ease the transition of thousands of military workers to Bethesda were not approved by Congress. In September, the National Naval Medical Center will become the new home for thousands of military workers transferred from the shuttering Walter Reed Army Medical Center. Outpatient visits are expected to double to nearly 1 million each year.

About $100 million in federal money had been designated for improving overloaded intersections around the medical center, which is expected to absorb 2,500 employees from Walter Reed.

But the $300 million package -- to be split among area hospitals -- was not included in the final spending bill passed by the lame-duck Congress.

"We won't be ready to handle the influx of patients and visitors -- which is expected to double," said Ilaya Hopkins, a member of the Coalition of Military Medical Center Neighbors and the BRAC Implementation Committee. "Gridlock will get worse. It's very frustrating that we're stuck with this unfunded federal mandate."

With an increased target on earmarks, Hopkins said there is a "real worry" that the money won't be restored in this year's federal budget, either.

However, a $20 million Defense Department appropriation was secured to improve pedestrian access to the Medical Center Metro station.

Maryland's Department of Transportation will use about $40 million in federal and state grants to improve intersections along Rockville Pike and Connecticut Avenue near the hospital. The work could begin as early as this summer.

About one of every five southbound vehicles traveling nearby on Rockville Pike during the morning rush is bound for the medical center, according to state transportation estimates.

By widening roads and adding turn lanes and traffic signals along Rockville Pike, Connecticut Avenue and Old Georgetown Road, officials expect to reduce rush-hour delays by 45 percent near the hospital.