Not-for-profit healthcare

Hunt Memorial Hospital District's distressed finances led to downgrades to Ba3 by Moody's Ratings and B-plus by S&P Global Ratings, with both giving it a negative outlook.

Medicaid cuts and tariffs are expected to pressure already struggling small rural and urban hospitals, including 18 in California that borrowed from the state.

The health network has struck up a partnership with the Dana-Farber Cancer Institute and is selling debt to finance the related infrastructure in Boston. 

The cuts to Medicaid enacted by Republicans in Washington have such enormous negative ramifications for New York State's hospitals, government and patients.

Tim Ruby has joined Wells Fargo as its healthcare, higher education and not-for-profit division executive. He will be based in Chicago.

An economic slowdown partially fueled by tariff turmoil has forced West Coast states to lower revenue projections and slash budgets.

The rating agency cited concerns about limited unrestricted reserves for lowering its rating outlook for more than $1 billion of debt.

The $839.5 million Harris County Hospital District bond sale will tap $2.5 billion of voter-approved debt authorization for a $3.2 billion expansion project.

The ratings agency is growing more pessimistic about the United States economy.

The "Golden Age of Public Finance," as it was called by industry pundits, is likely to face significant changes under the Trump administration.