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Federal budget bill could strip Pennsylvanians of Medicaid coverage, push rural hospitals to the brink

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. Sign up for Talk of the Town, a weekly newsletter of local stories that dig deep, events, and more from north-central PA, at spotlightpa.org/newsletters/talkofthetown. HARRISBURG — President Donald Trump’s […]

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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. Sign up for Talk of the Town, a weekly newsletter of local stories that dig deep, events, and more from north-central PA, at spotlightpa.org/newsletters/talkofthetown.

HARRISBURG — President Donald Trump’s “big, beautiful” budget bill could have a disastrous effect on the health of rural Pennsylvanians and the operations of the hospitals and other medical centers that care for them.

The federal budget proposal, which passed the U.S. House by a one-vote margin in May, calls for nearly $800 billion in Medicaid cuts over the next decade. It also includes a new 80-hour-per-month work or service requirement for Medicaid recipients between the ages of 19 and 64 who aren’t caregivers or who have disabilities. Among other changes, the bill would require verification of coverage eligibility every six months rather than annually.

While supporters of the budget bill argue that it will slow spending and safeguard government programs, critics say the cuts and new requirements will create more paperwork for states and make it harder to access essential care. Opponents also argue the changes would push struggling rural hospitals and other providers to the brink, and force them to scale back services or close entirely.

More than 3 million people in Pennsylvania — 23% — are covered by Medicaid, according to data from the state Department of Human Services, which administers the program. The agency estimates that more than 300,000 would lose Medicaid coverage under the proposal.

Val Arkoosh, secretary of the department, said the bill would not only hurt those losing coverage but “all of us who would face the real-life consequences of crowded emergency departments, increases in the cost of health insurance, and the catastrophic effects on economies and health systems in rural areas.”

More than 737,000 Medicaid recipients live in rural counties, where residents are typically older and more reliant on government-funded insurance programs. Such programs reimburse at lower rates compared to private insurance companies and haven’t kept up with inflation.

Cameron County Commissioner James Moate, a Republican, said the Medicaid reimbursement rate should have never been less than 100%.

“That’s why we have struggling hospitals,” he told Spotlight PA.

On average, Pennsylvania hospitals absorb a loss of 18 cents on the dollar for care provided to Medicaid patients, said Nicole Stallings, president and CEO of the Hospital and Healthsystem Association of Pennsylvania, which represents more than 230 hospitals statewide. In rural communities, the average loss is 26 cents on the dollar, she added in a May statement.

“Medicaid plays a vital role in the health of rural residents, and it is important to preserve this funding so that families can continue to access the care they need for healthier lives,” said Douglas Winner, chief financial officer for Penn Highlands Healthcare, a nonprofit system with nine hospitals in rural counties.

Penn Highlands President and CEO Steve Fontaine has told lawmakers that consolidating with other health systems and expanding into new areas has helped facilities survive. This strategy, which has helped Penn Highlands diversify its patient and insurance bases, is why the system expanded into Centre County, where resident numbers are expected to grow, he told lawmakers last year.

Still, the health system has shuttered services and reported operating losses over the past year.

Winner said Penn Highlands is “greatly concerned” about the proposed Medicaid cuts.

“Rural hospitals have experienced substantial cost increases for labor, drugs, and supplies,” he said in a statement. “Coupled with decreasing volumes, inadequate reimbursement rates, and ongoing staffing shortages — recruitment and retention — we are struggling financially.”

Advocates worry the cuts in the federal budget will force rural hospitals to slash services even more or close altogether. And once facilities end a service or shut down, they rarely reopen, Stallings told Spotlight PA.

Community health centers could also be strained. These facilities, also known as federally qualified health centers, provide services regardless of someone’s ability to pay and primarily see patients who use Medicaid and PENNIE, the state’s Affordable Care Act marketplace.

More uninsured people will likely lead to an increase in uncompensated care, said Eric Kiehl, director of policy and partnership for the Pennsylvania Association of Community Health Centers. And these facilities are already strapped for resources, he told Spotlight PA.

A surge in demand could cause these health centers to shutter core services — such as medical, dental, or behavioral health — reduce hours, or close, Kiehl said.

Pennsylvania’s U.S. House delegation voted along party lines on the federal budget bill, with Republicans supporting and Democrats opposing the proposal.

Medicaid spending totaled roughly $44 billion in fiscal year 2023. The federal government provided almost $28 billion of those dollars.

Democratic Gov. Josh Shapiro has said the state won’t be able to make up those dollars to support the Medicaid program. In a statement, Shapiro said he hopes “common sense and a concern for the people of Pennsylvania” will prevail in the U.S. Senate, where Democratic U.S. Sen. John Fetterman and Republican U.S. Sen. Dave McCormick disagree on aspects of the bill.

McCormick did not respond to a request for comment for this story. He has expressed support for the budget bill, which he says will reduce and slow government spending. During a Fox News forum, McCormick said he isn’t advocating for taking benefits from “vulnerable people” but is trying to ensure “people for whom the program was designed” benefit.

Fetterman called the plan “a bad bill,” telling Spotlight PA in a statement: “Republicans want to put more money in the pockets of the ultra-rich at the expense of hundreds of thousands of Pennsylvanians who will lose access to Medicaid if this disastrous bill is passed.”

SUPPORT THIS JOURNALISM and help us reinvigorate local news in north-central Pennsylvania at spotlightpa.org/donate. Spotlight PA is funded by foundations and readers like you who are committed to accountability and public-service journalism that gets results.

SUPPORT THIS JOURNALISM and help us reinvigorate local news in north-central Pennsylvania at spotlightpa.org/donate. Spotlight PA is funded by foundations and readers like you who are committed to accountability and public-service journalism that gets results.



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Penn State baseball earns commit from former Tampa infielder Kevin Karstetter | Penn State Baseball News

Another transfer is on the way to Happy Valley. Kevin Karstetter announced via X that he committed to Penn State. There’s no place like HOME…#WeAre 🔵⚪️ pic.twitter.com/HEvL2zElGY — Kevin Karstetter (@kpk34) July 11, 2025 The State College native has had a decorated career in his college journey so far. He earned FCSAA Male Athlete of […]

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Another transfer is on the way to Happy Valley.

Kevin Karstetter announced via X that he committed to Penn State.

The State College native has had a decorated career in his college journey so far. He earned FCSAA Male Athlete of the Year honors at the State College of Florida before heading to Arizona State for a season where he hit .260 in 39 appearances.

Last season was the peak of Karstetter’s career, as he won the D2 NCAA championship with Tampa. During his second year of NCAA baseball, Karstetter hit .335 with five home runs and stole 19 bases.

MORE BASEBALL COVERAGE


Penn State baseball draft profile | Paxton Kling has five-tool potential

Once a highly recruited prospect, Paxton Kling returned to his home state and became a super…

If you’re interested in submitting a Letter to the Editor, click here.





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Bryce Underwood Crowned CFB’s Top Freshman by Fans, Marking Historic Michigan Beginning

Bryce Underwood walked into Ann Arbor with a $12 million NIL deal and the weight of being college football’s top recruit. Fans call him the “best freshman in the country” before he’s even taken a snap. But with that kind of money and hype comes a question that’s splitting college football: Is he worth it, […]

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Bryce Underwood walked into Ann Arbor with a $12 million NIL deal and the weight of being college football’s top recruit. Fans call him the “best freshman in the country” before he’s even taken a snap.

But with that kind of money and hype comes a question that’s splitting college football: Is he worth it, or is everyone getting ahead of themselves?

Why Did Bryce Underwood Choose Michigan Over LSU?

The former LSU commit shocked the college football world on November 21, 2024, when he flipped to Michigan after nearly a year of pledging to the Tigers. The same day, he signed with the Wolverines, shifting the momentum of Sherrone Moore’s first season in Ann Arbor.

That decision, widely discussed across recruiting circles, also reinforced Michigan’s growing reputation in the NIL space. Underwood’s reported agreement with the university is believed to be worth between $10.5 million and $12 million over four years, making him one of the highest-valued recruits in college football history.

When College Football Report asked fans on X who they believed would be the top freshman in the country next season, responses poured in.

“Underwood and it’s not close,” one user wrote.

Another pointed out: “The True Freshman Running Back at Clemson is going to have a big year,”

“As a Michigan fan I hope it’s Bryce,” a fan remarked.

“Bryce Underwood might be the best player period,” another remarked.

What Makes Underwood’s Arrival at Michigan So Historic?

His arrival makes him the second No. 1 overall prospect to sign with Michigan in the modern recruiting rankings era, joining Rashan Gary (2016). He also joins a short list of elite prospects to pick the Wolverines, including Jabrill Peppers (No. 3 in 2014), Ryan Mallett (No. 5 in 2007), LaMarr Woodley (No. 4 in 2003), and Prescott Burgess (No. 5 in 2003).

Underwood’s high school resume was dominant. Over four seasons, he threw for 11,488 yards. He accounted for 179 total touchdowns with 27 rushing TDs and 152 passing TDs, winning two state championships and compiling a 50-4 record. His national spotlight grew even brighter when he became the No. 1 recruit before his junior year.

Read More: Analyst Predicts ‘Samurai Sword’ QB Bryce Underwood Could Turn Michigan into 2025’s Biggest Sleeper

Despite his accolades, Underwood’s youth and inexperience leave questions unanswered. He won’t turn 18 until August 19, 2025, just before Michigan’s opener against New Mexico. He enters a quarterback battle that features Fresno State transfer Mikey Keene and second-year player Jadyn Davis.

At 6’4″ and 208 pounds, Underwood possesses elite physical traits, including a powerful arm and the mobility to escape pressure and create big plays. Against weaker opponents like Central Michigan, his natural tools alone could give Michigan a decisive edge. However, how well he transitions to the college level remains uncertain, even as expectations soar.



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Hudson Valley NY College ID soccer camp

John Jay Cross River’s Dennis Galvan, left, pressures Fox Lane’s Gavin Morales during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches. Peter Carr/The Journal News Lakeland’s Lucas Boyko plays the ball during […]

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Hudson Valley NY College ID soccer camp

John Jay Cross River's Dennis Galvan, left, pressures Fox Lane's Gavin Morales during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

John Jay Cross River’s Dennis Galvan, left, pressures Fox Lane’s Gavin Morales during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

Lakeland's Lucas Boyko plays the ball during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Lakeland’s Lucas Boyko plays the ball during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

Fox Lane's Gavin Morales during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Fox Lane’s Gavin Morales during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

Lakeland's Lucas Boyko defends Ardsley's Tiernan Kenny during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Lakeland’s Lucas Boyko defends Ardsley’s Tiernan Kenny during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

John Jay Cross River's Dennis Galvan, left, fights for the ball with Yorktown's Stephano Alvarez during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

John Jay Cross River’s Dennis Galvan, left, fights for the ball with Yorktown’s Stephano Alvarez during the Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

The Hudson Valley College ID camp at Lakeland High School July 11, 2025. The soccer clinic and showcase camp was for local high school players to be observed by college coaches.

Peter Carr/The Journal News

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PWHL Seattle signs Anna Wilgren to one-year contract

The PWHL’s newest American franchise made another big signing on Thursday, as PWHL Seattle inked defender Anna Wilgren to a one-year contract that will keep her with the club through the 2025-26 season. Wilgren’s playing rights were acquired by Seattle after she was selected with the 10th pick of the 2025 “We’re excited to have […]

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The PWHL’s newest American franchise made another big signing on Thursday, as PWHL Seattle inked defender Anna Wilgren to a one-year contract that will keep her with the club through the 2025-26 season.

Wilgren’s playing rights were acquired by Seattle after she was selected with the 10th pick of the 2025

“We’re excited to have Anna representing Seattle this season,” said PWHL Seattle General Manager Meghan Turner in a news release. “Anna made an immediate impact in her first year with strong defensive play and the ability to contribute to all zones. She’s tough to play against and will be a great fit in our organization.”

The 25-year-old Wilgren, taken by the Montreal Victoire in the fifth round of the 2024 PWHL Draft, scored three goals and six assists for nine points in 30 regular-season games in 2024-25, as well as recording three assists during the Victoire’s playoff series against the Ottawa Charge.

“I am so excited to be a part of bringing women’s hockey to the West Coast,” said Wilgren. “The energy that Seattle fans brought to last year’s PWHL Takeover Tour was incredible. I can’t wait to play in front of such a passionate women’s sports fanbase every night with such a talented group of athletes.”  

Wilgren, a native of Hudson, Wis., spent four seasons playing college hockey at Minnesota State, scoring 12 goals and recording 30 assists for 42 points in 91 career games. In her fifth season, she transferred to Wisconsin, logging in two goals and 22 assists for 24 points in 40 games, helping the Badgers reach the 2024 NCAA Championship.

Wilgren joins a blue line that includes Cayla Barnes and Mariah Keopple, as well as Emily Brown, Megan Carter and Aneta Tejralova.



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‘Essence of the JCC’ soon to retire

“She’s been the power behind everything that happens here,” Lois Rittenhouse said with a smile for Barbara Sugarman, who was working in the lobby of the Friedman Jewish Community Center in Kingston. “She is one awesome lady,” said Cissie Ashley. “She’s been part of this place in such an intense way. The dedication she […]

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“She’s been the power behind everything that happens here,” Lois Rittenhouse said with a smile for Barbara Sugarman, who was working in the lobby of the Friedman Jewish Community Center in Kingston.

“She is one awesome lady,” said Cissie Ashley.

“She’s been part of this place in such an intense way. The dedication she has to Sara’s Table has been remarkable,” Rabbi Larry Kaplan said, referring to the JCC’s food pantry for the needy.

On a recent, ordinary weekday morning, the JCC was bustling with people coming and going from exercise class or Pickleball games, arriving to do volunteer work or to buy one of the kosher meals long-time employee Barbara Sugarman had ready for pick-up.

Because Sugarman, who recently turned 82, plans to retire next month after 67 years working for the JCC, a reporter visited and asked people how they feel about the woman who for decades has been synonymous with the Jewish Community Center.

“You should title your piece ‘Spot Reserved in Heaven,’ ” Pickleball player Jeff Lubin advised the reporter.

“She’s an enabler, in a good way,” Lubin continued. “I started teaching a class here (in biblical studies) and Barb helped me get it off the ground. With the bridge club, the men’s club, she asks, ‘What do you need?’ and she makes it happen.”

Back in the 1950s, Sugarman was a 15-year-old student at Kingston High School who wanted a summer job.

“All of my friends were working at the camp,” she said, noting the JCC maintained a camp at Twin Lakes at the time. “I called for a job and they said the staff was full but if I wanted to volunteer I could.”

Sugarman began working as a volunteer but by the time seven weeks of summer camp were over, the camp administration decided to pay her after all. Her salary for the whole summer was $35, paid in one lump sum.

With camp over for the season, Sugarman volunteered to work at the center through the rest of her high school career and while she was studying education at Temple University. Basically, she never left — not during the time she worked for the Bell Telephone Co., and not when she and her husband, the late Howard Sugarman, were raising their three children.

For 19 years she served as the Jewish Center Youth Regional Director and for more than 20 subsequent years she has served as director of adult and cultural programs, arranging holiday and educational programs, collecting food for the hungry and helping people every way she could think of.

“She’s a wealth of knowledge. She answers any question you have,” said co-worker Lisa Cope. “In the short time I’ve been here, about a year and a half, she’s like my best friend.”

“If you ever needed any kind of connection, she knew it,” said Gerri Kaplan, leader of the Midrasha School.

“I like people,” Sugarman said, offering a hint to the key to her success. “I’m a people person. I tell people to call me, even on a weekend, even at night. I like to be available.”

For Sugarman, it was difficult in recent weeks to tell person after person that an upcoming local history class at the JCC, to be taught by local historian Tony Brooks, had reached its limit and their names would be put on a waiting list.

More recently she was relieved to have the class moved to a larger space, so the 47 people on the waiting list could be notified that they were welcome to attend after all.

Making them happy made her happy.

“I can’t imagine this place without her,” said JCC president Jane Messinger. “She is the essence of the JCC and what we’re all about. She’s irreplaceable.”

“We’re going to remain friends,” Messinger said, giving Sugarman a fond hug. “Hopefully she’ll come back for a visit.”

“I’m going to miss the people here,” said Sugarman, whose next chapter involves moving to South Carolina to live with her son Jeff and daughter-in-law Heather, who are building a home there.

Other family members include daughter Wendy and her husband Scott Lowden, daughter Randi and her husband Aaron Chapin and grandchildren Katie Sugarman, Jacob Sugarman and Sydney Chapin.

Family and friends will celebrate Sugarman’s long career this weekend at a brunch, and she expects her last day at work will be in the middle of August.



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Isaac Howard Gives Utmost Praise to MSU

Former Michigan State star Isaac Howard was recently traded from the Tampa Bay Lightning to the Edmonton Oilers, signing a three-year, entry-level contract that will ultimately take his talents to the NHL next season. Despite the departure, Howard gives MSU a lot of credit. In his own words, Howard could “not be more grateful” for […]

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Former Michigan State star Isaac Howard was recently traded from the Tampa Bay Lightning to the Edmonton Oilers, signing a three-year, entry-level contract that will ultimately take his talents to the NHL next season. Despite the departure, Howard gives MSU a lot of credit.

In his own words, Howard could “not be more grateful” for the role that the Spartans played in his journey to the next level. He is the reigning Hobey Baker Award winner, given to the No. 1 player in college hockey, and was the main factor in why MSU won a second-straight Big Ten title.

As Howard prepares to embark on his NHL journey, he spoke to reporters in a virtual media availability this week to discuss multiple topics, including the role that the Spartan program played in his development and ultimate journey to the NHL.

“I mean, I couldn’t be more grateful for this place (MSU),” Howard said. “I had two of my best years here. I think this school and coaching staff, everyone just has such high class, and I think they’ve helped me a lot as a person outside of the arena, and I think that’s helped me on the ice.

“I focus a lot on play away from the puck and defensive stuff with (head coach Adam) Nightingale and all the other coaches, and I think they’re world-class. They preach development first, and I think if you can buy in, you’re going to get the most out of this place, and I think it’s worked for me, and I couldn’t be more grateful.”

The words from Howard are not only a major feather in the Spartan program’s cap for how well they have developed top talent, but it is also an incredible recruiting pitch. To hear the best player in college hockey admire MSU like he did and credit his teammates and coaching staff is crucial.

NHL training camp begins in late September, and Howard will certainly be on the ice with the team that has gone to back-to-back Stanley Cup Finals but has lost both times to the Florida Panthers.

Make sure to follow the official Spartan Nation page on Facebook, Spartan Nation, WHEN YOU CLICK RIGHT HERE, and be a part of our lively community group, Go Green Go White, as well WHEN YOU CLICK RIGHT HERE.

Ensure you also follow us on X @MSUSpartansOnSI.



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