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Obama switches gears, focuses on changing the Affordable Care Act conversation

Calls on governors to get over politics, cover citizens who remain uninsured

By David Furguson

Riding high from last week's Supreme Court win, President Barack Obama continued his victory tour today in Nashville, Tennessee, aiming to shift the focus from Affordable Care Act criticisms to improving the healthcare reform law. 

About 70 people picked by the White House will attend the closed event, notes USA Today

Obama hopes to harness the momentum of the Court victory to extend coverage to even more Americans through Medicaid expansion and other measures that will build on healthcare reform, the Associated Press reported.

"If we can get some governors that have been holding out and resisting expanding Medicaid primarily for political reasons to think about what they can do for their citizens who don't have health insurance but could get it very easily if state governments acted, then we could see even more improvement over time," Obama said.

Some 21 states are still refusing to expand their Medicaid programs.

Tennessee's Gov. Bill Haslam is one of the few Republicans who has tried to implement the ACA's Medicaid expansions for low-income citizens. Haslam attempted to add 280,000 low-income state residents to Medicaid, but was blocked by Republicans in the state legislature.

Other states where Republicans have blocked coverage for the poor include Texas, Georgia and Florida.

Physicians and other healthcare providers are arguing increasingly in the ACA's favor, urging state governments to expand coverage because it lets them intervene sooner in patient diagnoses, which dramatically cuts costs and improves the quality of care.

On Tuesday, members of the American College of Physicians (ACP) called on these states to expand their Medicaid programs--failing to do so would have dire consequences for those states' most vulnerable citizens, they said.

"These patients will still get sick, still come to hospitals and clinics for care, and will disproportionately still come to the emergency room for conditions that could have been more cheaply, easily, and comfortably treated through preventative and primary care," Hemant Sindhu, president of the Committee of Interns and Residents, a union of clinicians, said in an email to MedPage Today.

"This weakens those patients' health and our hospitals' finances, not to mention [it] is terrible healthcare economics and public health policy."

Beyond Medicaid expansion, doctors say they want to see quality metrics in place than enable them to ensure consistent care and "thoughtfully" control costs.

"We want to see robust, workable, sensible, verifiable, evidence-based approaches to quality measurement that aren't too onerous on physicians," the ACP's Wayne Riley told MedPage Today.

To learn more: 
- here's the USA Today story
- read the AP story
- check out the MedPage Today interviews

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Focus turns to Medicaid expansion in wake of King v. Burwell ruling