In 2009, President Obama told Congress, "Let there be no doubt, health care reform cannot wait."

On Thursday, more than three years after that announcement, his dream of affordable health care was realized.

But what is a victory on Capital Hill is being met with mixed reviews locally.

"I think it's outstanding," David Cunningham said.

Ivan Grabhorn disagreed.

"I'm not for it, because you can't afford it," he said.

In a city where health -- from education to research to care providers -- is a key contributor, this sweeping Affordable Health Act means a lot of different things to a lot of different people.

Executive Director of UT Medicine Dr. Carlos Rosende said for physicians, the act brings necessary changes.

"We needed to insure that the large number of persons who did not have any coverage, had some coverage (and that) they have access to medical care," Rosende said.

For Greg Gieseman, president and CEO of Community First Health Plans, a nonprofit insurance provider, it means providing healthcare coverage for tens of thousands of residents in Bexar County who currently go without.

"If the intent was to create access to care, it certainly has created a vehicle to do that," Giesman said.