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Jul 1, 4:59 PM EDT

Fresh off Supreme Court win, Obama pleads for cooperation to improve health care system


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NASHVILLE, Tenn. (AP) -- Fresh off a Supreme Court victory, President Barack Obama said Wednesday that he's "feeling pretty good" about the state of his health care law and pleaded for bipartisan cooperation on ways to make it work even better.

Obama said he wants to refocus the debate on improving health care quality, expanding access and eliminating waste now that the high court has upheld a key element of the Affordable Care Act.

"I'm feeling pretty good about how health care is going," Obama said before he removed his suit jacket and answered questions about health care from Tennesseans seated at tables in an elementary school cafeteria.

Obama's choice to visit Tennessee was deliberate. The state's Republican governor, Bill Haslam, tried to expand Medicaid under the health care law to cover more than 200,000 state residents - only to be stymied by state legislators of his own party.

Obama argued to his audience - and during a Twitter question-and-answer session immediately after the event - that health care coverage rates could be vastly improved if more governors and lawmakers would accept the federal government's offer of billions of dollars of federal money to pay to expand Medicaid to cover millions more low-income Americans in their states.

About 20 states, most of them led by Republican governors and including some heavily populated places like Florida and Texas, have refused to expand Medicaid. Obama has accused them of losing sight of what's good for their constituents.

"I think because of politics not all states have taken advantage of the options that are out there," he said. "Our hope is that more of them do."

The Supreme Court handed Obama a major victory on health care last week when it upheld federal financial aid to millions of low- and middle-income Americans to help pay for insurance premiums regardless of where they live.

Obama declared immediately after the ruling that the law is "here to stay." He cited progress under its provisions but said more work was needed to "make health care in America even better." In Nashville, he talked about making sure people know about the law's benefits, including free preventive care, help for seniors on prescription medication and prohibitions on insurers denying coverage based on a prior illness.

While Obama talked up what he says is good about the law, the law's Republican opponents highlighted what they say is bad about it.

"The latest Supreme Court ruling won't change Obamacare's multitude of broken promises, including the one that resulted in millions of Americans losing the coverage they had and wanted to keep," Senate Majority Leader Mitch McConnell, R-Ky., said Wednesday. "And the ruling won't change the skyrocketing costs in premiums, deductibles, and co-pays that have hit the middle class so hard over the last few years."

Obama surrounded himself Wednesday with two women who shared their health care stories in letters to him.

Accompanying the president aboard the Air Force One flight was Natoma Canfield, an Ohio cancer survivor who wrote in 2009 about being forced to drop her health insurance after she could no longer afford the monthly premium.

After arriving in Tennessee, Obama made room in his limousine for Kelly Bryant, of Nashville, who wrote about finding affordable insurance under the law to treat her breast cancer. He picked her up on the way to the event, even holding an umbrella to shield her from a pounding rain.

"I never imagined in my wildest dreams that anyone would read it, let alone him," Bryant said to introduce the president. "I am living proof of a president who listens and cares about the American people."

Asked about the lack of Medicaid expansion in Tennessee, Obama lamented the politics he said are at play and urged lawmakers to find a "uniquely Tennessee solution."

"It is unfortunate that getting this thing done got so political," he said. "Washington is kind of a crazy place. But that doesn't mean every place has got to be crazy."

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Associated Press writer Lucas Johnson contributed to this report.

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