WASHINGTON - House Republicans are claiming a triumph by finally approving their centerpiece bill scuttling much of President Barack Obama's health care law.

But its pathway through the Senate will be at least as bumpy. And there's little doubt the measure will change, assuming it survives.

The House approved the bill Thursday by a vote of 217-213. There were 20 GOP defections.

Senators are already talking about preventing some of the House bill's Medicaid cuts. Some don't like its easing of Obama coverage requirements on insurers, and others think its tax credits must be redirected toward lower-income people.

Senate Finance Committee Chairman Orrin Hatch of Utah says senators must focus "on the art of the doable."