Conservative groups are pushing President Trump to make ObamaCare repeal a priority in 2018, even as some Republicans signal a desire to move on from the issue.

letter to Trump signed by 43 right-leaning groups calls for health-care reform to be the focus of the fast-track process known as reconciliation this year. Using that process would allow Republicans to repeal ObamaCare in the Senate without Democratic votes, but it would also preclude them from using the tool for other priorities like welfare reform.

“Now that tax reform legislation is signed into law, it is time to deliver on the rest of the promises made to the American people to free them from the shackles of ObamaCare,” states the letter, which was led by Independent Women’s Voice.

Other groups on the letter included Heritage Action, Club for Growth, Americans for Tax Reform and Susan B. Anthony List.

Republicans already failed to repeal ObamaCare after a months-long struggle in 2017, and nothing significant has changed since then that would now make the path easier. In fact, the obstacles appear even greater now that Democrat Doug Jones has been elected to the Senate from Alabama, cutting the GOP majority to a single seat, 51-49.

Asked about ObamaCare repeal last month, Senate Majority Leader Mitch McConnell (R-Ky.) told NPR, “we’ll probably move on to other issues.”

Conservative groups don’t want to move on, however, and are appealing to Trump for help persuading GOP leaders.

“We encourage you to move quickly to fulfill your and Congress’s promises to the American people,” the letter states.

“Health reform must be the focus of the 2019 budget reconciliation instructions,” the groups add. “And your administration’s leadership can help the Senate and the House design a bill that can muster the votes needed for passage of true health reform to give Americans more choices of more affordable health coverage and care that meet their needs.”

Hadley Heath Manning, director of policy for Independent Women’s Voice, said that the groups have been in touch with White House staff over the holidays and that they knew to expect the letter. White House aides had an “encouraging tone,” she said, but the views of Trump himself are hard to know.

“I can’t say what the attitude of the president is, but that’s the reason we’re sending the letter,” Manning said.

Trump has been unpredictable on the issue. Most recently, he has touted the repeal of the individual mandate as “essentially” repealing ObamaCare. He also pointed to an executive order that will loosen the rules for skimpier, cheaper plans called association health plans, when calling for bipartisan action on health care.

“I believe that because of the individual mandate and the associations, the Democrats will and certainly should come to me and see if they can do a really great health-care plan for the remaining people,” Trump told The New York Times last week.

Asked about the letter, the White House on Tuesday did not make a firm commitment to prioritizing ObamaCare repeal this year, saying the issue would be discussed with congressional leaders.

White House deputy press secretary Hogan Gidley said in a statement that ObamaCare has been a “complete disaster,” before adding, “Our Administration has already taken huge steps to dismantle Obamacare by repealing the unfair and unaffordable individual mandate.”

“Ongoing efforts to fix our healthcare system will be one of the topics discussed in the meetings with Congress this week,” Gidley added.

If the GOP decides not to pursue ObamaCare repeal in 2018, they could use the fast-track reconciliation process for welfare reform, an issue that Speaker Paul Ryan (R-Wis.) has already identified as a top priority.

It is possible welfare reform could encompass elements of health care, such as Medicaid, but the conservative groups want to make sure ObamaCare is not left out.

Passing anything through reconciliation would require adopting a budget first, which could prove difficult in an election year. And McConnell has thrown cold water on the idea of doing welfare reform on a partisan basis.

Some Republican lawmakers, notably Sen. Lindsey Graham (R-S.C.), one of the authors of a leading ObamaCare replacement bill, are still pushing for repeal this year. And with conservative groups taking his side, it is possible the issue will be pushed back to the forefront.

“We think it’s too important of an issue to leave unaddressed,” Manning said.