The House Budget Committee on Thursday approved 19-17 a motion to send the Republican legislation to repeal and replace the 2010 health care to the full House for consideration.

Republican Reps. Mark Sanford of South Carolina, Dave Brat of Virginia, and Gary Palmer of Alabama — all members of the conservative House Freedom Caucus — voted against the motion, despite a plea from panel chairwoman Diane Black of Tennessee.

“To my Republican colleagues who have doubts today, I encourage you: Don’t cut off discussion. Stay in this effort and help us enhance this proposal by advancing it out of committee and pushing for further conservative reforms,” she said during her opening statement.

The legislation will now advance to the House Rules Committee, where Republican lawmakers are hoping to make several changes to the bill. But the conservative and moderate factions of the party remain divided on what direction those changes should take.

Conservatives, like Rep. Mark Meadows of North Carolina, chairman of the Freedom Caucus, would like to see a halt on the 2010 health law’s Medicaid expansion in 2018, as opposed to 2020 as is currently included in the legislation. But Rep. Charlie Dent of Pennsylvania, who leads the moderate Tuesday Group, said such a switch would be a non-starter for him and many of the group’s members.