COLUMBUS, Ohio -- Ohio lawmakers could vote Thursday morning to reinstate the Medicaid expansion freeze vetoed last week by Gov. John Kasich. Or not.

Political observers expect the House to consider veto overrides during a rare, post-budget session on Thursday. But Speaker Cliff Rosenberger said House Republicans will decide tonight whether to vote to override the Medicaid freeze or any one of the 47 line items Kasich in the 2018-19 state budget bills.

Veto overrides need the approval of three-fifths of each chamber -- 60 in the 99-member House and 20 in the 33-member Senate. Of the 66 Republicans in the House, 59 voted in favor of the entire budget bill.

"It's all going to come down to whether we have the members who want to do this," Rosenberger told reporters after a morning event celebrating a $5 million earmark to provide training to Ohio elected officials, a budget provision that survived Kasich's veto pen.

But Rosenberger said lawmakers technically have until the end of the legislative session, Dec. 31, 2018, to overturn any of the governor's vetoes and could decide months from now to hold a vote.

"At the end of the day, this is not a fight with the governor," Rosenberger said. "This is about policy differences that we're having."

While legislators mull their options, public pressure is mounting from hospitals, health professionals and advocates for poor Ohioans to let Kasich's Medicaid expansion veto stand. Hundreds of expansion supporters, including former Gov. Ted Strickland, gathered on the Statehouse lawn Wednesday at a rally organized by the Ohio Medicaid Coalition, a group of more than 200 organizations.

Lawmakers are also getting calls supporting the freeze, thanks to a major push from the Ohio chapter of Americans for Prosperity, a conservative nonprofit funded by Republican megadonors Charles and David Koch.

What's at stake

Kasich went around the GOP-controlled legislature in 2013 to expand Medicaid, the joint state-federal health insurance program for poor and disabled people, to a greater number of working poor Ohioans. Currently, the expansion qualifies an individual earning about $16,600 a year or a family of four making about $33,950.

The Kasich administration estimated 366,000 Ohioans would initially be eligible for the program, but more than 725,000 have signed up. The federal government pays a higher share for the expansion population than regular Medicaid enrollees -- 95 percent compared to about 60 percent -- a deal for the state.

But Congress is considering scrapping the expansion, a component of the Affordable Care Act, which would make the state's share jump from the projected $281.6 million in 2018 and $338.6 million in 2019. Ohio GOP lawmakers have argued the money is better spent on other services.

Kasich's Office of Health Transformation estimates 500,000 people would lose health care coverage within 18 months of freezing expansion because they couldn't re-enroll after a period where their incomes rose above the eligibility level.

The Kasich administration has also warned exempting people with alcohol or drug addiction or mental illness from the freeze, as proposed in the budget, would be illegal. Medicaid, and the expansion, comprises more than half of the $1 billion the state says it is spending to fight Ohio's opioid addiction crisis.

Pressure to keep Medicaid expansion

Attendees at Wednesday's rally waved signs that said "Don't freeze us out" and "People over politics." They chanted, "Save Medicaid and save lives." And they pulled out their phones to Tweet, email and get phone numbers for about a dozen House Republicans targeted by the coalition.

Dr. James Misak, assistant professor of family medicine at Case Western Reserve University School of Medicine, said Ohio's Medicaid program is one of the most efficient and effective in the nation.

Misak said he's seen how Medicaid helps people deal with chronic health problems and return to work. Without it, Misak warned, more people will wait until they need to visit the emergency room to treat a health problem.

"[The freeze] will shift the burden to providers and make health care more expensive for all of us," Misak said.