If voters reject the proposed constitutional amendment it will have a ripple affect throughout the state's medical and prison systems.
"We don't want any prisoners released before the time they're to be released. According to the sentence that was opposed to them by the courts," said Houston County Sheriff Andy Hughes.
And that's what could happen, prisoners being released without serving their full sentence.
Houston County Sheriff Andy Hughes says that scenario could trickle down to a local level.
"If the state prisons were to quit taking new inmates that would definitely back us up and possibly overcrowd the county jail again which is something that we definitely don't want."
Something they don't want and haven't had for a while.
"Our county jail population has been very manageable for the last year or so we've been staying sometimes under 350 inmates," explained Sheriff Hughes.
At a news conference Thursday, local government leaders and the medical community encouraged voters to approve the measure.
"40 percent of children in alabama are covered by alabama medicaid and a little over half of our deliveries are also covered by alabama medicaid so without proper medicaid funding, without realizing the importance of medicaid services by taking away that funding you also jeopardize the health care for all children," said Dothan Pediatrics Dr. Michael Ramsey.
And that in turn will impact other groups.
"We run three adult care centers that are funded through funding that comes through this source if this funding is not available and those services are cut i don't know where these people will go," said Wiregrass Rehab and Adult Care Dr. Jack Sasser.
City leaders say 30 to 35 percent of income that comes into the county comes from the medical field.
Voters will cast ballots on Tuesday, September 18th.
Polls will be open from 7 am to 7 pm.