For the fifth time in 20 years, Ohio voters are poised to weigh in on a ballot question that would authorize casinos in Cincinnati, Cleveland, Columbus and Toledo.

If the measure passes Tuesday, it could deal another blow to Indiana’s already struggling gambling industry.

Southeast Indiana casinos—Grand Victoria in Rising Sun, Belterra near Vevay and Hollywood in Lawrenceburg—could lose up to 38 percent of their admissions to new competitors in Ohio, costing the state up to $86 million in wagering tax revenue, according to an estimate from Indiana’s Legislative Services Agency.

About $600 million a year flows from riverboat casinos into the state’s general fund, making it one of the leading sources of state revenue.

But gamblers have cut spending as the economy soured, and Ohio isn’t the only potential competitor looking to take a bite out of Indiana’s piece of the pie.

Kentucky Gov. Steve Beshear wants to legalize either slot machines or casino-style gambling at racetracks throughout his state, and Michigan is considering expanding its tribal casinos.

Indiana could lose up to $250 million in casino tax revenue if all the proposed out-of-state casinos are approved, the LSA told a legislative study committee last month.