We equalize our rating on Assistance Publique - Hopitaux de Paris (AP-HP) with our long-term sovereign rating on the Republic of France (AA+/Negative/A-1+, unsolicited). This reflects our view that there is an "almost certain" likelihood that the French state would provide timely and sufficient extraordinary financial support to AP-HP in the event of financial distress. We consider AP-HP to be a government-related entity (GRE). Under our criteria for rating GREs, we base our rating approach on our view of AP-HP's: "Critical role" for the French state, given its unique position in the French health care system as the country's (and Europe's) largest hospital and university medical center and its flagship center for medical research and publications. It accounts for about
