It's because Pa makes it a royal PIA to get one, never mind getting one re-issued.
I went through this with one for the Mrs. First you need documentation from your medical provider with a valid reason. Then you provide this information to PENNDOT, they verify all this. Then they further question for how long the condition will exist, and either approve or deny. This took over 90 days for a 1yr windshield hanger. It then takes an additional 90+ days to approve a permanent one, requiring further medical documentation. Luckily I saved the original paperwork when it was issued when we left it in a rental car in Vegas. It still took 2 months to get it re-issued.
It is totally ridiculous.
Just print one and laminate it.