S&P Global Ratings lowered its long-term rating to 'AA-' from 'AA' on the Chester County Health and Education Facilities Authority, Pa.'s debt issued for Main Line Health System (MLH). The outlook is stable. MLH is the parent company of Main Line Health. The rating action reflects our view of MLH's sizable operating losses in fiscal 2022 and the first three months of fiscal 2023 with an anticipated operating loss for full fiscal 2023 after variable performance in recent years, combined with a weakened balance sheet resulting from a decline in unrestricted reserves, resulting in metrics no longer commensurate with the 'AA' rating. Gross revenue from the obligated group, which consists of Main Line Health System, Main Line Health Inc., Main