Republican goal to balance budget could mean deep cuts to health programs Anxiety is rising among House Republicans about a strategy of appeasement toward fiscal hard-liners that could require them to embrace not only the sequester but also sharp new cuts to federal health and retirement programs. Letting the sequester hit was just the first step in a pact forged in January between conservative leaders and Speaker John A. Boehner (R-Ohio) to keep the government open and the nation out of default. Now comes step two: adopting a budget plan that would wipe out deficits entirely by 2023. The strategy runs counter to warnings from prominent Republicans such as Louisiana Gov. Bobby Jindal against becoming "the party of austerity." Just as GOP lawmakers are tacitly endorsing sequester cuts to the Pentagon, long a sacred cow, they fear the balanced-budget goal will force them to abandon a campaign pledge not to reduce Medicare benefits for those who are now 55 and older. "I know a number of people who have real concerns about where this is going," said Rep. Peter T. King (R-N.Y.), who said Medicare cuts targeting people as old as 58 are under discussion. "One of the last presidents to balance the budget was Herbert Hoover," King added darkly, referring to the penny-pinching Republican blamed for deepening the Great Depression. GOP leaders say the strategy has been necessary to persuade their right wing to postpone a fight over the debt ceiling until later this summer, and to support a bill on the floor this week to fund the government through the end of September. The payoff, they say, will be a budget framework that holds the promise of paying down the national debt without higher taxes. There's plenty of political peril associated with this. Whether we as a conference have the stomach to look at Medicare and Social Security spending will be the make-or-break part of the deal," said Rep. Tom Cole (R-Okla.), a senior member of the Budget Committee. But I think setting an ambitious goal was wise. If we can't do it, the country can't do it. Budget Committee Chairman Paul Ryan (R-Wis.) plans to present the new framework next week and put it to a vote in the House before the Easter break. In a brief interview, he said the year-end "fiscal cliff" deal made balancing the budget easier than it would have been last year, when he offered a plan that wouldn't balance the budget until nearly 2040. Independent analysts estimate that Ryan would have to cut about $100 billion more in 2023 to balance spending and revenue. My first reaction [to the balanced-budget pledge] was the same as everybody else's: God, what . . . is he going to do? I thought last year's budget was crazy and appalling," said Robert Greenstein, president of the left-leaning Center on Budget and Policy Priorities. But this year's budget doesn't have to be all that different. Still, Democrats are salivating over the framework. Just as the pain of the sequester starts affecting schools, parks and airports, Democrats say, Republicans will be promoting a vision of extreme austerity that voters rejected in the 2012 presidential campaign - which featured Ryan as the GOP vice presidential nominee.