WASHINGTON (AP) -- In private pitches to Democrats, President Barack Obama says he will persuade Congress to pass his health care overhaul even if it kills him and even if he has to ask deeply distrustful lawmakers to trust him on a promise the White House doesn't have the power to keep.
That, in a sometimes darkly joking way, is what the president is telling Democratic House members as he begins an all-out push to coax Congress into passing his proposals despite voters' misgivings and Republicans' dire warnings.
``He made the case, 'Listen, we put in a very hard year working on health care reform and the time for action is now,''' said Rep. Ron Kind, D-Wis., one of several Democrats who met with Obama at the White House on Thursday.
Obama joked that the political battle has contributed to the recent rise in his cholesterol, Kind said, and the president noted how ironic it would be if health care drove him to his grave.
But Obama is anything but sickly these days, making health care pitches Monday in Philadelphia and Wednesday in St. Louis, and instructing aides to address every question or concern Democratic lawmakers possibly can raise.
Some answers, however, rely more on faith than fact. Confronting party unrest on his left and right, Obama is calling for political courage, citing historic opportunities and essentially saying "trust me'' in areas inherently murky, uncertain and out of his control. The process for getting health care legislation through Congress is tough enough already, and Republicans are determined to derail it.
Obama told House liberals last week that he understands their frustration in seeing priorities -- such as allowing the government to sell insurance in competition with private companies -- dropped from the revised legislation. He promised to work with them in the future to improve health care laws, said Rep. Barbara Lee, D-Calif., who leads the Congressional Black Caucus.
``He said, `This is the first step, a foundation that we can build upon,''' she said. "He made a commitment to work with us on all the issues that are outstanding, and there are many.''
It's unclear whether Obama can keep such promises, especially with Republicans expecting to gain House and Senate seats this fall.
Obama is asking his party's House moderates to have a different kind of faith. The party's strategy calls for House Democrats, despite many misgivings, to go along with a health care bill the Senate passed in December. Obama would sign it into law, but senators would promise to make numerous changes demanded by House Democrats. Because Senate Democrats no longer have the numbers to stop GOP filibusters, the changes would have to be made under rules that require only simple majority votes.
Republicans are playing on House Democrats' suspicions of their Senate colleagues, saying Senate Democrats may not keep their end of the bargain. The taunts often hit their marks.
``A big issue for the House is putting suspenders with belts on the plan to ensure we don't get left holding the bag with just the Senate bill by itself,'' said Rep. Joe Courtney, D-Conn.
Democratic leaders are considering several ways to reassure nervous House members, who felt burned last year when they voted for climate legislation -- a vote many now regret -- and the Senate never did its part. Possibilities include a letter pledging compliance, signed by 51 or more Senate Democrats, or a parliamentary move that essentially would suspend the House-passed bill until the follow-up Senate action takes place.
Congressional insiders say the likeliest path involves Obama and others convincing House members that Democrats, who control 59 of the Senate's 100 seats, have more than enough votes for a simple majority, especially when Vice President Joe Biden can break a tie.
Even if the House does its part, Republican senators promise to use every tool they can to kill the Senate's follow-up actions with delaying tactics, such as introducing unending streams of amendments. Democrats say they believe they can grind down efforts over time, leaving Republicans exhausted and perhaps vulnerable to renewed accusations of obstructionism.
A bigger worry for Democrats is that a dispute over abortion restrictions could cause as many as a dozen House Democrats to switch to ``no'' on health care even though they voted ``yes'' last year. If that happens, Obama and other party leaders will press some of the 39 House Democrats who voted ``no'' last year to switch sides. Such a switch can be defended politically, party leaders say, because the revised bill is less costly and excludes the contentious public insurance option.
Republicans are working overtime to thwart such strategies by sowing doubts and fears among Democrats. They say Obama is marching his party toward political suicide in a year when he's not on the ballot.
GOP Sen. Lamar Alexander of Tennessee said the president and House Democratic leaders are asking their colleagues to ``hold hands, jump off a cliff and hope Harry Reid catches them,'' a reference to the Senate Democratic leader from Nevada.
Even if the Senate keeps it promise to make changes that the House wants, Alexander said, Republicans will try to repeal the legislation and make it a campaign issue in every race this fall.
White House and Democratic leaders counter with their own warnings to nervous House Democrats who might consider switching from ``yes'' to ``no'' on health care. Why would Republicans, they ask, shout warnings if they truly believed Democrats were blundering their way to catastrophe?
They also say Republican challengers will heap even more scorn on a vote-switcher, reviving versions of the flip-flopping taunt used against 2004 Democratic presidential nominee John Kerry: ``He was for it before he was against it.''
It's better, these party leaders say, to pass the health care bill and spend the last few months of the 2010 campaign telling voters about the ways it will help them.
``You've got to go out and sell that product and stop worrying about the process,'' said Rep. George Miller, D-Calif., chairman of the House Education and Labor Committee. ``And the president is a very powerful salesman for that product.''
Associated Press writers Ben Evans, Erica Werner and Ann Sanner contributed to this report.