This story was produced by the State College regional bureau of Spotlight PA, an independent, nonpartisan newsroom dedicated to investigative and public-service journalism for Pennsylvania.

BELLEFONTE — As federal Medicaid cuts loomed over Pennsylvania’s rural hospitals, health advocates focused on safeguarding funding for these already strained facilities and programs that help keep their doors open during this year’s state budget talks.

The $50.1 billion state budget — passed by the legislature and signed by Democratic Gov. Josh Shapiro after a four-month impasse — maintains support for rural and critical access hospitals. It preserves spending on programs that have faced cuts and closures in rural areas. And it increases state Medicaid spending as the feds prepare to cut roughly $1 tr

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