Voters heading to the polls this fall could have a huge hand in the future funding for the skilled nursing industry.

Seventeen states are set to elect new governors for 2019, thanks to term limits, incumbents who lost in the primary or open seats. And eight of those new leaders will reign in states that have chosen not to expand Medicaid, nursing homes’ largest source of funding. Florida, Georgia, Kansas and Wisconsin are just a few that are up for grabs.

Consumer advocacy group Families USA noted this week that upcoming gubernatorial and legislative elections will likely determine whether states open the Medicaid wallets wider, or further tighten eligibility restrictions. Nursing home funding could be affected by varying degrees.

“There is just a huge swing in terms of the outcome of this election from really buttressing the existing levels of coverage for adults and securing them to significantly damaging them,” Families USA Senior Director of Health Policy Eliot Fishman, said on a press call Wednesday.

Three conservative-leaning states, Idaho, Nebraska and Utah, also have Medicaid expansion measures on their ballots in November.

For further details on what’s at stake in the midterm elections, Families USA has an audio recording of its informational phone call, a fact sheet and an election toolkit for healthcare voters.