A doctor and patient consult in Miami. GOP Gov. Rick Scott of Florida says he will delay implementing the health care law.

STORY HIGHLIGHTS

Washington (CNN) -- Repeal and replace -- or at least resist -- is the Republican mantra in the wake of last week's Supreme Court ruling upholding President Barack Obama's signature health care reform law.

Presumptive GOP presidential nominee Mitt Romney promises to get rid of Obamacare if elected, and at least four Republican governors say their states will hold off implementing main provisions of the 2010 law to see what happens in November.

However, analysts and industry experts contend the reality is that health care reform will happen out of necessity, whether through the Affordable Care Act or the momentum it already has created since being passed over two years ago.

According to a report by PricewaterhouseCoopers' Health Research Institute, 14 states and the District of Columbia have made "significant progress" toward implementing reforms, while another 19 states have made "moderate progress," leaving 17 states -- or about a third -- that have yet to change their laws or take other steps toward implementation.

The report, titled "Implications of the U.S. Supreme Court Ruling on Healthcare," says all players in the health care industry -- state governments, hospitals, insurance companies, employers and drug companies -- need to participate in the emerging reform process or risk getting left behind.

"Despite the political uncertainty, private-sector initiatives -- accentuated and accelerated by the law -- are moving forward," the report says. "The crucial question now is: Will health reform define your organization, or will your organization define the post-reform landscape?"

Republicans launch blitz against health care law

A repeated recommendation in the report advises industry leaders to "stop putting off key decisions," and it specifically calls on states to "stop taking a wait-and-see approach to health reform implementation."

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States face rising tide of health reform