Perry (and other Gov's) will be in full oposition until after the election. Then quietly start implementing it and if questioned will say something along the lines that the law forced them to opt in due to how it was written and its all Obama's fault who set the deck against state rights.
They can go against it for so long before economics catches up to them. That is, the unisured overwhelming the emergency rooms, health care costs skyrocketing in their state due having to take on anyone with pre-existing conditions and not implementing this will not help them job wise. Companies with less than 50 employee's do most of thier business within the state they reside so its not that easy to up an move to a state that doesn't partake of the ACA. And large companies already provide health insurance in order to retain workers, have a positive public persona, etc. So there is not incentive there either.
And if Romney does win and they take the Senate.....Ten bucks says it will be the exact same plan, but spun differently with a few minor changes. The only way they cannot institute some sort of Health Care Reform is to reverse Reagan's EMTALA law (ironic isn't it?).
But then again....today's Republicans are not the Party of Reagan who: Raised Taxes, implemented EMTALA (a health care law), would not get involved in Mid-East wars (he cut and ran in Lebanon), oh and his tax cuts? They had a Keynesian bent. And lets not forget he negotiated with America's enemies (USSR), as Gov of California allowed abortion and although he advocated an anti-abortion admendment in word, did little else to promote it...
...and have to quote Reagan on FDR: "one of history's truly monumental figures," "an American giant, a leader who shaped, inspired, and led our people through perilous times."....and he voted for him 4 times.
Not saying Reagan was perfect, he did make some grevious mistakes, but he was a product of his time. But I have to wonder, would he be a Republican today given what its become? I seriously doubt it. Funny, when I bring this up with Republicans I know, they essentialy put thier hands over thier ears and yell "LA LA LA I can't hear you LA LA LA".