By MARY SHEDDEN | The Tampa Tribune Published: November 10, 2012 Updated: November 10, 2012 - 7:36 AM

Gov. Rick Scott doubled down that he could outlast Obamacare. He lost.

Tuesday's re-election of President Barack Obama, along with the return of a Democratic-led Senate, guarantees the Affordable Care Act will keep moving forward, including here in Florida, where Scott has been among its staunchest opponents.

Scott placed his bet just days after the U.S. Supreme Court upheld the law in June, saying Florida wouldn't implement two key provisions: the expansion of Medicaid for poor adults and the creation of a state-run marketplace where residents shop for and buy commercial health insurance policies.

He was confident Republican presidential nominee Mitt Romney would win the election and promptly repeal the contentious law. But experts fromboth sides say Obama's win and wide voter sentiment that there should be an end to partisan bickering will force Scott, Florida's Legislature and the U.S. Congress to seriously address health care reform.

The situation reminds some of what it was like 40 years ago, when reluctant states eventually introduced Medicaid programs to avoid losing millions in federal reimbursements.

"People believe that over time all states will have to participate even if they do it kicking and screaming," said Dave Rogoff, director of the University of South Florida's Center for Leadership in Public Health Practice.

Soon, leaders in Tallahassee and Washington, D.C., will have to decide which parts of the 2,000-page law they will phase in, and how and if they can install those parts by the Jan. 1, 2014, deadline.

The most immediate issue for the federal government: making realistic cuts to health care spending as part of an end-of-year deficit reduction debate.

"You don't have the money or administrative ability to pull it (all the law's proposals) off as is," said Tom Miller, a health care fellow with the American Enterprise Institute and an Affordable Care Act critic.

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Obama's re-election forces Scott to seriously address health care reform