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U.S. Supreme Court rulings on the Affordable Care Act leave the Oklahoma Health Care Authority in a precarious balancing act.

Although states now have the option to opt out of the ACA's Medicaid expansion, the authority must still prepare to absorb up to 200,000 additional users into its SoonerCare program while it awaits policy guidance from Gov. Mary Fallin and the Legislature.

Luckily, the OHCA has a history of adapting to change, Director of Planning and Development Buffy Heater told several hundred attendees at Thursday's OHCA Board Retreat at Tulsa's Hyatt Regency Hotel.

In some areas, like information processing, the authority has already scored …