Fitzpatrick, a moderate who represents Bucks County, was one of a handful of Republicans to vote against a procedural vote to move the bill forward late Wednesday night. He was the only Republican “no” not to reverse on that vote by the early morning hours as negotiations went on. The House voted 219-213 to advance to final debate.

House Republican leaders are scrambling to shore up support for President Trump's massive domestic policy bill amid pushback to the Senate's changes as the GOP seeks to approve the final version of the legislation ahead of a July 4 deadline to get the bill to the president's desk.