Pennsylvania Budget Proposal Concerns Rural Healthcare Providers

Providers warn of potential service cuts and hospital closures without more state investment in rural healthcare.

Published on Feb. 11, 2026

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Governor Josh Shapiro's proposed $53 billion Pennsylvania state budget includes investments in agriculture, technology, and education, but local healthcare providers are concerned that rural healthcare needs are being overlooked. They warn that without substantial state funding, rural hospitals and services face the risk of further closures and cuts, leaving many residents without access to critical care.

Why it matters

Rural healthcare in Pennsylvania is already in a 'state of crisis,' according to union leaders, and federal budget cuts have exacerbated the problem. Providers fear that without increased state investment, more rural hospitals will close and services will be consolidated, forcing residents to travel long distances to receive care. This could have serious consequences for vulnerable populations who rely on local, accessible healthcare.

The details

The 2025-2026 state budget allocated over $60 million to critical access, financially distressed, and rural hospitals, but healthcare union leaders say this was not enough. They project over a dozen hospital closures in the state over the next five years, with rural hospitals at the highest risk. Providers warn that federal and provider cuts to Medicare and Medicaid will be the greatest threat, putting more strain on already strained systems and leading to increased uncompensated care in emergency rooms.

  • Governor Shapiro's 2026 budget proposal was released in February 2026.
  • The 2025-2026 state budget allocated over $60 million to rural healthcare.
  • The Hospital and Health System Association of Pennsylvania is projecting over a dozen hospital closures in the state over the next five years.

The players

Governor Josh Shapiro

The governor of Pennsylvania who proposed the $53 billion state budget.

Matt Yarnell

President of SEIU Healthcare Pennsylvania, a healthcare workers' union.

Rick Hoover

A Pennsylvania resident who has been battling multiple sclerosis for 20 years and relies on state-funded in-home care.

Rachel Emigh

Hoover's caregiver for over a decade, who is concerned about low wages and lack of benefits for home healthcare workers.

The Hospital and Health System Association of Pennsylvania

An organization that represents hospitals and health systems in the state.

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What they’re saying

“You're going to see more and more services that are really important that are based in communities, get moved to their flagship hospitals, which just means people are going to have to travel, you know, many, many, many miles and many, many counties to get the care that they need in their region.”

— Matt Yarnell, President of SEIU Healthcare Pennsylvania

“Without the funding, I couldn't afford to have the care that I have for the hours that I have. Basically, I couldn't live my life. I would be miserable. That's a fact. I've been there. I've done that.”

— Rick Hoover

“There's no benefits. The wages are extremely low. If something happened to my husband, I couldn't afford my mortgage or my utilities or anything really.”

— Rachel Emigh, Caregiver

What’s next

The governor's office said the budget will include $193 million in federal funding for the Rural Health Transformation Plan and a $10 million state investment in rural healthcare access, with an anticipated $26.7 million federal match.

The takeaway

The proposed state budget's lack of substantial investment in rural healthcare has raised concerns among providers that critical services and hospitals could be at risk of closure, leaving many Pennsylvanians without access to essential care. Advocates are calling for the state to prioritize funding for rural healthcare to address this growing crisis.