Health reform got President Obama's official, final approval Tuesday.
He signed the bill into law before a crowd of hundreds of supporters at the White House.
But before the ink dried, there are already efforts on Capitol Hill to repeal health reform either in Congress, or in the courts.
Obama was surrounded by supporters including the late Ted Kennedy's wife Vicki as he signed the "Patient Protection and Affordable Care Act" into law.
"The bill I’m signing will set in motion reforms that generations of americans have fought for and marched for and hungered to see," said the President.
But this is just the beginning.
On Tuesday the Senate debates fixes to the new law including taxes on expensive health insurance plans and closing the Medicare "donut hole" for prescriptions.
Plus: 9 states are taking the administration to court claiming health reform puts an undue burden on their budgets and their residents.
"We call it a living tax on an individual. Just for sitting in a chair and not doing anything, to be having to pay a penalty if they don't buy an insurance policy," said Florida Attorney General Bill McCollum.
With Americans split on reform President Obama’s still campaigning.
He's got a rally scheduled Thursday in Iowa.
"One more speech about same bad bill isn't going to change minds in America," said republican congressman Mike Pence of Indiana.
"As people become familiar with it, it will sell itself," said Senior White House Adviser David Axelrod.
Republicans lost their first bid to get rid of that second bill the Senate's debated on Tuesday.
But they're still trying to get this law repealed.
Those who back the bill believe they'll quickly gain public support because before the mandate to buy insurance takes effect, those popular consumer protections kick in like preventing insurance for dropping people for pre-existing conditions.