WASHINGTON—The House of Representatives was headed toward a final vote Thursday to pass President Trump’s sprawling tax-and-spending bill, after party leaders worked through resistance from a handful of rank-and-file members.

Brian Fitzpatrick, a Pennsylvania Republican who is one of the most moderate in his party, was a surprising 'no' vote against advancing the bill. Unlike other Republicans who have voted 'no' and are now being courted in person by House Republican leaders, Fitzpatrick raced off the floor and away from the chamber after he voted no.