Top Republican lawmakers have begun softening their tone on President Barack Obama's health care law as they begin to wrestle with the details of overhauling the medical system while ensuring that millions of people aren't left without access to health care.

They have gone from talks of gutting the Affordable Care Act to language that instead suggests fixing it.

“There are some of these provisions in the law that probably will stay, or we may modify them, but we're going to fix things, we're going to repair things,” Rep. Greg Walden, chairman of the Energy and Commerce Committee, said to reporters this week.

Sen. Lamar Alexander, chairman of the Health, Education, Labor and Pensions Committee, said in a hearing this week that Congress should "repair" the law before forging ahead on a full overhaul.

"No one is talking about repealing anything until there is a concrete practical alternative to offer Americans in its place," the Tennessee Republican said.

The notable shift in messaging is aligning more closely with Democrats, who acknowledge some of the law's shortcomings and have said Obamacare should be made stronger.

But consensus hasn't quite been reached, even among Republicans. House Speaker Paul Ryan of Wisconsin said that "repair" and "replace" essentially amounted to the same thing, and Vice President Mike Pence said on Fox News that Republicans were "absolutely committed" to simultaneously repealing and replacing the health care law.

The party's more conservative members, including those in the House Freedom Caucus, were dismayed at the turn in tone. Rep. Mark Meadows, the group's chairman, said the Affordable Care Act was "unrepairable."

“We need to repeal it," he said. "We need to replace it. If you want to call that a repair, so be it, but I don’t know that that makes it any more palatable to the folks back home.”

This isn't the first time that some Republicans have altered their messaging. The Affordable Care Act was passed in 2010 without a single Republican vote, and at the time Republicans vowed to "repeal" the law. As Americans began to gain coverage, however, Republicans evolved their language to "repeal and replace."

Republicans have set repeal in motion, moving swiftly to pass a measure that allowed them to begin putting together a budget process that will undo parts of Obamacare. A tentative deadline was set for Jan. 27, but some leaders are saying that a final bill might not come until March or April. While they haven't settled on the details of a replacement plan, this week they presented four drafts for consideration.

Without Democrats, Republicans are limited in how much they can undo the law.

But support will also need to come from the public. On the one hand, some middle-class Americans have complained that the prices for coverage are too high, particularly when they don't qualify for subsidies others receive for plans sold on the exchanges. On the other hand, threats of repeal create panic among people who say Obamacare's coverage allowed them to access life-saving treatment.

Congress is facing additional pressure from health insurers, who have said the uncertainty makes them wary about continuing to participate in the exchanges. The health care system relies heavily on their participation so consumers can access competitive prices and a wide range of options.

One possibility for a bipartisan measure will be for Congress to continue federal payments that allow insurers to reduce out-of-pocket costs for low-income people. Without them, some Americans could lose subsidies this year. The Trump administration has some of its own ways to entice participation from insurers, including by restricting loopholes consumers can take to avoid paying for coverage in full – something insurers say is costly for them and influenced their decisions to limit their exchange participation in 2017.

Aetna, one of the insurers that reduced its involvement in the exchanges, said it was still weighing its participation for next year, but that it was engaging in talks with lawmakers.