The outlines of a possible health care compromise continued to emerge Wednesday, but it remains unclear that House Republican leaders have enough “yes” votes to repeal Obamacare.

In a promising development for reform supporters, several activist conservative groups that last month helped kill the first version of the American Health Care Act blessed ideas negotiated by conservative Rep. Mark Meadows (R-N.C.) and moderate Rep. Tom MacArthur (R-N.J.). But many moderates remain leery.

“We think the MacArthur amendment is a great way to lower premiums [and] give states more flexibility, while protecting people with pre-existing conditions.”

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Under the proposal developed by Meadows and MacArthur, states would be allowed to opt out of some of the provisions of the Affordable Care Act, including mandates that insurance companies not charge higher premiums to people with pre-existing health conditions and that they cover 10 “essential benefits.” States that opted out would be required to set up high-risk pools to help people with pre-existing conditions.

House Speaker Paul Ryan (R-Wis.) gave the approach a big thumbs-up Wednesday.

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“We think the MacArthur amendment is a great way to lower premiums [and] give states more flexibility, while protecting people with pre-existing conditions,” he told reporters on Capitol Hill. “Those are the three things we want to achieve. You gotta remember, Obamacare is collapsing, and people are getting hit with double-digit premium increases.”

Rep. Jim Jordan (R-Ohio), a member of the conservative House Freedom Caucus, said in a statement that he is willing to support the MacArthur approach as a compromise to build momentum toward a key campaign promise that Republicans have run on for years.

“While I remain committed to replacing Obamacare entirely, I can support this new version of the bill moving forward,” he said in the statement. “It is our best chance to pass a bill through the House that will actually reduce the cost of health insurance for everyday Americans.”

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Rep. Mo Brooks (R-Ala.), a Freedom Caucus member who opposed the original repeal effort, said in a statement he will support this one because it is “drastically better than what it was a few weeks ago.”

A moderate member of the House, Rep. Chris Collins (R-N.Y.), acknowledged that many fellow moderates continue to have concerns that the proposal would create an undo burden for older health insurance customers and people with chronic illnesses.

But he noted that people would not be affected unless their states decide to seek waivers.

“This would not impact New York in the least,” he told CNN’s Jake Tapper. “At some point, you’ve got to compromise. You gotta take a tough vote. And the main thing is, we’ve got to deliver on this problem the president and all of us made to America when they elected us to majorities in the House and the Senate and put [President Donald] Trump in the White House.”

One thing the GOP plans to repeal Obamacare have lacked until this week is support from conservative interest groups.

“Since the AHCA was released, conservatives have done the GOP an enormous favor by pushing for needed changes that will benefit taxpayers, including the immediate repeal of Obamacare’s taxes and block-granting of Medicaid funding to states,” Club for Growth President David McIntosh said in a prepared statement. “While we’re still short of full repeal, this latest agreement would give states the chance to opt out of some of Obamacare’s costliest regulations, opening the way to greater choice and lower insurance premiums. It’s a solution that we’ve supported for weeks, and the time to move forward is now.”

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McIntosh added that he hopes the Senate improves the bill and stated that GOP moderates who still oppose repeal “are proving that they simply don’t want to keep their campaign promises to get rid of Obamacare.”

Heritage Action for America said it no longer would insist on opposition to the American Health Care Act as a “key vote” in its legislative scorecard. Michael Needham, the group’s president, praised MacArthur and Meadows for good-faith efforts to reach consensus.

“To be clear, this is not full repeal and it is not what Republicans campaigned on or outlined in the Better Way agenda,” he said in a statement. “The amendment does, however, represent important progress in what has been a disastrous process. Given the extreme divides in the Republican Party, allowing Texas and South Carolina to make different decisions on health-insurance regulations than New York and New Jersey may be the only way forward.”