HARRISBURG — Residents of rural Pennsylvania face unique barriers to health care, broadband and economic opportunity.
About 3.4 million people, or about 26% of Pennsylvania residents, live in the Commonwealth’s 48 rural counties, according to the Center for Rural Pennsylvania, a state agency.
The Governor of Pennsylvania has the power to deal with a wide range of rural issues. On Nov. 8, voters here will choose from five gubernatorial candidates, including frontrunners Democratic Attorney General Josh Shapiro and Republican Sen. Doug Mastriano of Franklin County.
The two leading candidates offer different approaches to revitalizing rural Pennsylvania. Spotlight PA breaks down its position on several major issues.
In Pennsylvania, access to health care in rural areas is shrinking, with some hospitals like the Bradford Regional Medical Center slashing services and others closing.
There is limited access to other health services like mental health and addiction treatment, according to studies from the Center for Rural Pennsylvania. Emergency services are also struggling to get people the care they need on time. Retaining the healthcare workforce also remains a challenge as hospitals grapple with staffing shortages.
Both candidates support promoting access to telemedicine. Mastriano has backed a bill that would, and Shapiro voices his support for expanding access to telemedicine on his campaign website.
Mastriano also supported and voted for Peyton’s Law, which helps educate student-athletes and their parents about the importance of testing to identify heart conditions that can lead to sudden cardiac arrest, which is crucial in rural communities in due to limited access to emergency services.
Mastriano is also a key sponsor of a bill that would cap the price of insulin, which affects people in rural areas as they face higher risk factors for diabetes and have access to less services.
Shapiro advocated for affordable health care in rural communities and said he would “strengthen the pipeline for healthcare providers in underserved areas” on his campaign website.
In 2007, when Shapiro was a state representative, he proposed a bill that would forgive medical school doctors loans if they stayed in Pennsylvania for at least 10 years.
Shapiro’s campaign told Spotlight PA it would extend the student loan relief program for nurses to every qualified nursing student. The plan would double the amount of relief provided up to $15,000 in loan relief and provide full loan forgiveness to nursing students who choose to practice in a state-identified underserved community for five years.
Shapiro said he also supports initiatives like the Pennsylvania Rural Health Model, which is an alternative payment structure funded by the Centers for Medicare & Medicaid Services that tests whether hospitals can improve their finances and services with fixed budgets. . Currently, 18 Pennsylvania hospitals are participating in the model.
In addition, Shapiro promised to restore Pennsylvania’s Emergency Medical Services Operating Fund, which partially funds EMSs across the Commonwealth, and said he would work with lawmakers to get drug prices under control.
As attorney general, his office sued the University of Pittsburgh Medical Center Health System to pressure it into a settlement with Highmark Health Insurance. The dispute between the healthcare companies could have cut off thousands of patients from UPMC’s 11 hospitals, many of them in rural parts of the state.
According to the Federal Communications Commission, at least 13% of rural Pennsylvanians lack access to broadband, but federal funds provide the state with the ability to build the infrastructure needed to support access.
In September, Governor Tom Wolf, a Democrat, announced that $500 million from the American Rescue Plan Act would go to local governments to invest in infrastructure, including broadband.
Up to $1 billion in federal funding can potentially be spent on broadband expansion. However, a 2004 law prevents local governments from building their own broadband networks, limiting how much of that infrastructure money will actually go to expanding access.
Shapiro’s campaign told Spotlight PA he would prioritize expanding quality and affordable broadband access to rural parts of the state by backing the new Pennsylvania Broadband Development Authority and establishing full subsidies for low-income households with high internet prices.
Shapiro was also part of a bipartisan coalition of attorneys general that in 2017 opposed a broadband industry petition to stop states from enforcing bogus advertising laws on internet speeds.
Mastriano did not respond to questions about his stance on broadband, but in a March press release he announced more than $800,000 in funding that would go towards expanding high-speed broadband internet. throughput in Franklin County.
Pennsylvania’s population is expected to become more urban and less rural by 2040, according to a 2014 study by the Center for Rural Pennsylvania.
Out-migration from rural areas and shrinking traditional industries such as manufacturing present ongoing challenges for rural Pennsylvania’s workforce.
The Center for Rural Pennsylvania surveyed 9th and 11th graders in rural school districts in 2021 and found that “few students said they were satisfied with current job opportunities or chances to advance in their local communities.”
The Pennsylvania state government has established workforce development initiatives and programs in many departments, including the Wolf’s Manufacturing PA Training-to-Career Grant Program, which works with “local makers to identify and teach missing critical skills to entry-level candidates”, depending on the administration.
“Pennsylvania commits less money to apprenticeship programs today than we did under Governor Casey,” Shapiro’s campaign told Spotlight PA. “As governor, I will direct the State Board of Education to prioritize career education…I will also create an independent Office of Economic Development and Workforce that will work directly with businesses to help them recruit the next generation of talented young workers and triple the total number of apprenticeships statewide.
In 2021, Mastriano voted for SB 486, which would change state law to establish a unified workforce investment system and provide grants for job training as well as industry partnerships. The bill awaits consideration by the State House.
Pennsylvania’s $81.5 billion agriculture sector supported 301,900 jobs and $14.5 billion in labor income in 2019, according to the state Department of Agriculture.
Rising prices for equipment and fertilizers have become a financial burden on farmers, forcing small farms – often owned and operated by families – to close in recent years.
A member of the state Senate Agriculture and Rural Affairs Committee, Mastriano voted for the 2019 Pennsylvania Farm Bill in both committee and the state Senate. The legislation, the nation’s first state-based farm bill, passed with bipartisan support.
The Wolf administration has touted the bill for creating the Center for Agricultural Business Development of Pennsylvania, funding programs to expand the state’s transformative capabilities, and providing the agriculture industry with incentives to invest in agriculture.
Mastriano is a key sponsor of a bill that would amend the Safe Farming Areas Act to increase funding for the Farming Conservation Easement Purchase Program and loosen the terms of eligibility so that more farms can participate.
He called the proposal “essential to maintaining food security and protecting against supply chain instability for the Commonwealth and our nation.”
Mastriano published a “Plan to prioritize PA farmers” on Twitter, where he said he would end school property taxes to help reduce the tax burden on farmers, preserve farmland, reduce state regulations in the agricultural sector and support the industry state dairy.
While eliminating property taxes is a popular proposal, to replace lost school revenue under his plan — a reduction of nearly $13 billion, according to the Pennsylvania State Education Association — Mastriano told WRTA in March that Pennsylvanians will face “a modest increase in sales tax and income tax.”
Both candidates say they will increase dairy processing capacity in Pennsylvania, albeit by different means. Mastriano wants to do this by cutting red tape, while Shapiro wants to offer tax incentives for businesses.
Shapiro told Spotlight PA he would help lower the cost of agricultural production by updating Pennsylvania’s low-interest loan and grant programs and making it easier for farmers to receive direct support. . Shapiro also said he would provide tax incentives to attract new dairy processing facilities to Pennsylvania.