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WASHINGTON - With the clock ticking down to Sunday's votes on the $940 billion health care package, President Obama and House Speaker Nancy Pelosi labored Friday to sustain their momentum in the face of dissent in Democratic ranks over abortion and other issues.

Democratic leaders persuaded four more House members to support the overhaul after initially opposing it, but they still need votes from a pivotal bloc of lawmakers who remain concerned that the proposal would open the door for the federal funding of abortions.

More than 200 House members have said they will vote against the bill. That leaves Democrats little margin for error as they attempt to gather the 216 votes needed for passage among the lawmakers -- including Rep. James Oberstar, D-Minn. -- who remain publicly undeclared.

Speaking to thousands of supporters Friday in Fairfax, Va., Obama predicted a "tough vote" as he prepared to meet with House Democrats in a final rally at the Capitol on Saturday. But he said: "We are at the point where we are going to do something historic this weekend."

House leaders publicly predicted victory, but they kept private their own vote count as they continued to woo the undeclared Democrats. Their search reportedly dwindled to a dozen or so lawmakers.

Those involved said the pitches were being made on a case-by-case basis, with the final version of the legislation being sold in some cases on the basis of its expansion of insurance coverage to millions of Americans and in others on findings that it would markedly reduce the deficit. The White House said that, just this week, the president had spoken 64 times to wavering lawmakers, often in one-on-one meetings in the Oval Office.

"There are as many rationales as there are members," said Rep. Robert Andrews, D-N.J., who has been working closely with Pelosi, D-Calif., to lay out the benefits of the health legislation to rank-and-file Democrats.

GOP vows tough floor fight

Republicans were trying to keep a count almost as closely as the Democrats and warned that the movement of Democrats into the yes column did not make approval of the measure a certainty, particularly given continuing uncertainty over abortion. "I just think it is clearly false momentum," said House Minority Whip Eric Cantor, R-Va. "The votes still aren't there."

The House Republican leader, Rep. John Boehner of Ohio, readied for a ferocious floor fight. He said he would demand that lawmakers call out their votes one by one in the chamber. Other Republicans said they would unleash every procedural weapon available to stop the bill.

Meanwhile, Democratic lawmakers tried to lock down more wavering Democrats, while a group of the party's social conservatives pushed for more restrictions on abortion services.

Those holdout lawmakers, most of whom hail from the Midwest and are Catholic, generally support the overall bill. But they have voiced objections to how the Senate bill would handle insurance coverage of abortions. It currently requires any woman who buys an insurance plan with the help of federal subsidy to send her insurer a separate check to pay for any abortion benefit that is included in the health plan. One potential compromise could include staging a vote, separate from the health bill, on stronger provisions against abortion.

"I want to vote for the bill. I just need to take care of a few issues before I can," Oberstar said Friday.

It was not clear if the bill could win approval without some concessions to Democrats seeking tighter restrictions.

Among wavering Democrats whose backing was being sought were Rep. Jerry Costello of Illinois, Kathy Dahlkemper of Pennsylvania, Steve Driehaus of Ohio, Paul Kanjorski of Pennsylvania, Marcy Kaptur of Ohio, Daniel Lipinski of Illinois and Alan Mollohan of West Virginia. The leadership was also appealing to Democrats who had voted against the measure but had since announced that they would retire -- a decision that could provide more freedom to take a politically difficult position.

Pelosi lost one closely watched lawmaker when Rep. Jason Altmire, D-Penn., said he would not switch his "no" vote from last year.

Trying to put out brushfires

Party leaders also scrambled to put out other brushfires, including concerns raised by some Democrats that the package would not eliminate regional disparities in Medicare payments to doctors. Liberals such as Reps. Peter DeFazio of Oregon and Michael Capuano of Massachusetts said they would withhold their support unless the formulas were rewritten -- a move backed by a group of hospitals that includes the Mayo Clinic. "It does not cost three times as much to do an appendectomy in Miami as it does in Portland," DeFazio said. "This has to be fixed."

Pelosi acknowledged the concerns and said she is working with lawmakers from Iowa, Minnesota, Oregon, Washington and Wisconsin to reach an accord.

The last-minute vote movement -- together with House leaders' continuing efforts to address members' concerns -- underscored just how fluid the vote count remains. Democrats said the most difficult task would be getting the last few decisive votes. "The last yard is the hardest," said Rep. Chris Van Hollen of Maryland, a member of the Democratic leadership, "but we will get into the end zone."

The Washington Post, Los Angeles Times, New York Times and McClatchy News Service contributed to this report.