Many Republicans are philosophically against the idea of expanding government programs and opposed to the federal health care law that calls for mandated health coverage. But the warnings issued a year ago that supporters of Medicaid expansion would face opposition come election time certainly seems to have had an impact, too.
"It would be nice if they were making this decision from the heart, but if it takes a threat to do it, that's OK, too," said John McAvoy, a founder of the Toledo tea party.
That group, along with the Northwest Ohio Conservative Coalition, has been talking with potential candidates to run against Sears, polling voters and knocking on doors in her district. One name that has emerged as a possible challenger is Rich Iott, a businessman who lost a bid for Congress three years ago against Democratic incumbent Marcy Kaptur in northwest Ohio.
Until now, McAvoy said, they have agreed with Sears, the third-ranking Republican in the Ohio House, on "probably 99.99 percent of the issues." But her stance on Medicaid is non-negotiable, he said.
He warned that Kasich could also face a cold shoulder from conservatives in his re-election bid next year.
"If you want the support of the conservative base, you have to take a conservative position," said Linda Bowyer, chairwoman of the Northwest Ohio Conservative Coalition.
Bowyer said it's very likely someone will run against Sears if she continues to back Medicaid expansion.
Sears initially was skeptical about expanding Medicaid when the governor said in February that he supported the idea. She now says making health care more widely available to the working poor is the right thing to do.
"They're only seeking care at the worst possible time and that's when they are in absolute crisis," she said.
Sears put forward a bill last spring that would have expanded Medicaid and required new enrollees to share in the costs. "How do you stare at a problem and not seek a solution?" she asked.
The pressure from conservative groups to oppose expansion has stopped some of the supporters from stepping out and announcing their support, she said. About five other lawmakers told her they are standing on the sidelines until they see House lawmakers come up with a new Medicaid proposal within the next few months, she said.
"I don't mind taking the arrows right now," Sears said.