President Barack Obama's health care initiative has cleared its first big hurdle in the House, with lawmakers voting to advance the debate.

The House voted 242-192 in favor of a must-pass procedural measure setting the terms for the debate. All 177 Republicans, joined by Democrats, voted to block the debate.

With Obama urging them on in a rare personal visit to Capitol Hill, Democrats pushed toward a final vote late Saturday on the bill, which would reshape the U.S. health care system and extend coverage to millions of the uninsured.