CLEVELAND -- There's a crucial vote Monday that's important to 275,000 struggling Ohioans and to Governor John Kasich.
Kasich's asking the 7-member State Controlling Board to vote on accepting federal money that would allow the expansion of Medicaid.
Kasich said he's "optimistic" about its passage during remarks at a Friday event to rally supporters of expansion.
Kasich told the group to "say your prayers this weekend."
Kasich talks of expansion as being the right thing to do.
"Could you imagine being in a position where you have no health insurance--you have absolutely no health insurance and you wake up and you're sicker than a dog and you've got nowhere to go....or you wake up and your sweet little daughter has a problem and you've got nowhere to go," he asked.
Some lawmakers and conservative groups are threatening to sue if the measure passes, calling the vote an illegal end run on the legislature.
Republican opponents have blocked an up or down vote on the issue, but included language that would block the expansion in the state budget.
Kasich vetoed that provision.
Thirty-nine House Republicans have filed a petition protesting Kasich's use of the Controlling Board.
Some conservative groups are threatening to sue to block expansion, calling the Plan B approach through the Controlling Board illegal.
They also argue expanding of the program would deliver another benefit that's an incentive for people not to seek jobs.
Kasich said," This is not a program to encourage dependency..It is a program designed to construct a bridge so people can be functioning in a way they can contribute."
And they also argue it would increase Federal spending on an ineffective program.
Maurice Thompson of the 1851 Center for Constitutional Law says, "I think there's a pretty strong legal argument against this manuever, when the general assembly passed the budget bill they explicitly prohibited expansion of Medicaid to this class."
Kasich needs four votes on the board. One member works for him and two are Democratic lawmakers, all certain yes votes.
Four Republican lawmakers form the rest of the panel.
One, Senator Chris Widener from Springfield, is not facing reelection. And speculation centers on him as the possible difference-making vote.
A host of speakers talked about Medicaid's importance to the mentally ill, addicts, working unemployed and veterans.
It's also important to hospitals bottom lines. Uninsured patients become uncompensated charity care. And insurance would enable many to get preventive care and eliminate more costly treatment for serious conditions.
According to groups supporting expansion, more than 72,000 Cuyahoga County residents would get coverage.
Expansion would mean more revenue too. The Clinic spends more than $150 million a year on charity care.
Clinic Dr. Linda Snyder said, "We can keep our hospitals and providers financially healthy as well as our patients. We view this as a win win for the state and its residents."
The Clinic has pushed hard for expansion. The vote comes at a time when the region's largest employer is making substantial budget cuts, offering early retirements and warning of possible layoffs.
The Greater Cleveland Partnership, the region's biggest business, group also supports expansion.