President Barack Obama touts Obamacare in Miami ahead of open enrollment

President Barack Obama praised his signature health care reform law in Miami on Thursday, blaming Republicans for the fact that Obamacare has struggled in certain areas and calling on them to work with his successor to create a smoother system.

During a speech at Miami Dade College, Obama blamed criticism of the Affordable Care Act largely on a misunderstanding of how the law works, before providing examples of how it could be improved.

"For all the good that the Affordable Care Act is doing right now, for as big a step forward as it was, it's still just a first step," Obama said. "It's like building a starter home – or buying a starter home. It's a lot better than not having a home, but you hope that over time you make some improvements."

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The president's remarks come as consumers face diminishing choices and rising costs on Obamacare's health insurance exchanges, where qualified people who don't get employer-sponsored coverage can purchase a tax-subsidized health plan.

Open enrollment season for exchange plans this year begins only one week before Election Day. Democratic presidential candidate Hillary Clinton has vowed to make improvements to the law if elected, while her GOP rival, Donald Trump, has called for its full repeal.

Obama acknowledged there are "legitimate concerns" with how the health care law is working, and called for a public option to compete with private health plans – a proposal he put forward earlier this year in an article published in the Journal of the American Medical Association. Clinton also has endorsed a public option in a move seen as a nod to progressives and her primary rival, Sen. Bernie Sanders of Vermont.

The health care law has driven the rate of uninsured Americans to a record low of 8.6 percent, yet it has faced criticism even among Democrats. Former President Bill Clinton, for example, recently said Obamacare has led to a system that's the "craziest thing in the world," while Minnesota Gov. Mark Dayton, also a Democrat, said the law was "no longer affordable for increasing numbers of people."

Most opposition, however, has come from Republicans in Congress, who have taken numerous votes aimed at hobbling or repealing Obamacare, which also has faced several Supreme Court challenges. Enacting a public option would require an act of Congress, and Obama on Thursday encouraged the next presidential administration to work with lawmakers to "smooth out the kinks" in the law.

"Maybe now that I'm leaving office, maybe Republicans can stop with the ... repeal votes they've taken, and stop pretending that they have a serious alternative, and stop pretending that all the terrible things they said would happen have actually happened, when they have not, and just work with the next president to smooth out the kinks," Obama said, even suggesting the law's name could be changed to Reagancare after former Republican President Ronald Reagan, or to Paul Ryan-care, after the current GOP House speaker.

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Obama also highlighted popular provisions in the law, including its mandate that preventive services be covered with no co-pay, its extension of insurance coverage to children who want to stay on their parents' plans until age 26, and its barring of coverage discrimination against people who have pre-existing conditions.

"You're getting better quality even though you don't know that Obamacare is doing it, " he said. "Thanks, Obama."

He additionally focused his attention on those affected by some of the law's current shortcomings.

For instance, health officials have struggled to enroll younger, healthier people who are key to helping insurance companies profit under the exchanges, and who are needed to balance out the risk pool of older, sicker enrollees. Obama said such enrollment issues have been especially prevalent in states run by Republican lawmakers who don't want to see the law work.

Surveys of uninsured people have shown affordability is a top reason some forgo purchasing a health plan, but Obama stressed during his speech that tax credits will offset rising premiums for most exchange enrollees.

He also pointed out that 19 states – including Florida – have not expanded Medicaid to cover low-income people.

"If your governor could put politics aside ... and do what's right, then more than 700,000 Floridians would suddenly have access to coverage," Obama said.