Moody's Investors Service has confirmed the "Aa2" rating on Midland (Texas) County Hospital District's $106 million of general obligation debt and revised the outlook to negative.
The "Aa2" rating is based on a number of factors, including MCHD's large tax base, lack of significant competition and low debt burden.
The negative outlook reflects MCHD's weakened economic performance, as well as the financial challenges throughout the state as Medicaid has not been expanded.