Michael Curry, president of the Massachusetts League of Community Health Centers, speaks at the State House. (Image via Mass. Governor's Flickr archives)

THE CROWD, gathered inside the Omni Boston hotel in the city’s Seaport district on Tuesday night, represented the various sectors of the Massachusetts economy, from health care and academia to financial services and real estate. 

As the attendees of the Greater Boston Chamber of Commerce’s annual meeting mingled, talk inevitably turned to what’s happening in Washington, DC. They are “trying to figure out the impacts of the executive orders, the direction of the tariffs, and the wide range of decisions coming out of Congress and out of the White House, what the implications are for their various sectors,” said Michael Curry, who was among three people honored that evening by the chamber as a “Distinguished Bostonian.” 

Curry, 56, has spent nearly 30 years walking around Capitol Hill, Boston City Hall, and the State House on Beacon Hill. He rose through the ranks of the Massachusetts League of Community Health Centers, becoming the president and CEO of the group in 2021. The organization represents 52 health centers that serve more than one million patients. 

His economic sector, health care, is affected like all the others by congressional chainsaws and White House whipsawing, and community health centers are considering partnerships, mergers, and acquisitions, with implications for their patients. “I can tell you who our patients are,” Curry said. “These are people who need access. They’re disproportionately poor. Up to 60 percent of our patients are people of color. They’re immigrants.” 

It’s a population in need of MassHealth, the state’s Medicaid health insurance program geared towards low-income residents. The largest program in the state’s annual budget, MassHealth is also heavily dependent on money coming from the federal government. Thirty percent of the Massachusetts population (2.1 million residents out of 7.1 million) are on Medicaid. Forty-eight percent of Massachusetts children are covered by MassHealth, according to a Blue Cross Blue Shield of Massachusetts Foundation report.  

With Medicaid on the chopping block as House GOP lawmakers advanced a spending bill, potentially leading to millions of people across the country losing coverage, Curry sat down with CommonWealth Beacon to delve into what’s happening in DC and how it could affect Massachusetts. This interview has been condensed and edited for clarity. 

COMMONWEALTH BEACON: Can you describe the issue at a 30,000-foot level? 

MICHAEL CURRY: I have to remind people I don’t care if you’re a Republican, Democrat, MAGA, super liberal, whatever the polar opposites of that spectrum would be, the bottom line is, if you don’t have health insurance, you don’t get care. Not until it’s critical to get care, which means that you have less chance of survival, which means you suffer longer. And as human beings, we should want that for no one. So our goal should be to make sure that people have a primary care provider, that they can get their cancer diagnosed at stage one instead of stage four, that they can manage that diabetes or that heart disease or that asthma, and you can’t do that without a card in your pocket, without insurance. 

The quote that I often say is, “Pay now or pay greater later.” The whole notion of that is, we can keep the cost down, you can get care at a health center. It’s saving by keeping you out of the emergency room or inpatient in a hospital for weeks and days, weeks and months, for your illness. Paying now or pay greater later is not just about money, but labor productivity. It’s also about the lives of the folks that we expect to be in our labs, to be driving our trains, or picking our fruit and vegetables, and teaching our classes. 

CWB: President Trump met with House Republicans and said basically don’t mess with Medicaid. But it seems like there are moves to still cut or touch it. How do you interpret that? 

CURRY: We have to all come to a common definition on what “touch” means. I think there’s a fundamental disagreement on what would be undermining and disruptive to Medicaid as we know it today, in a way that is not in the best interest of Americans. And part of that is work requirements, any administrative complexities that drive people off coverage, that they’ll get lost and again, pay now or pay greater later. We’ll see them elsewhere, at higher cost settings, or they’ll prematurely die. 

CWB: What’s the issue with work requirements? 

CURRY: Most people on Medicaid already work. Many jobs don’t pay you well enough to afford insurance. We know that there is a pervasive problem in this country of underinsurance or employers who avoid providing health coverage because there’s a pretty high cost to provide health insurance for your employees. And then you add the average employer, there’s a 10 percent increase for employers every year on insurance coverage that you offer your employees. To some degree that’s not even sustainable, right? So more and more of your overall budget, nonprofit and for-profit, is health insurance coverage. 

The concern is that if you start tightening the requirements, and you start adding too many administrative complexities, like work requirements, people churn off of Medicaid, and now they’re uncompensated care. So the worst scenario is that a person no longer has Medicaid, and now we’re still paying for it anyway, because now they’re showing up more sick and in settings where states end up having to – as our state has the health safety net – to cover that care through that mechanism, which is already underfunded and in financial distress. 

Now you’re driving more people to episodic and emergency care, which is not what we want to do as a system. And work requirements, it won’t increase employment, it’ll just decrease coverage.  

CWB: What would the federal cuts mean for Massachusetts if they go through? 

CURRY: It would be unsustainable without the federal partnership, the federal funds. So, you cut programs, right? You might cut benefits, right? Oral health under Medicaid is an optional program, optional coverage. And states like Massachusetts could choose to not cover oral health, which means that that’s an implication for health centers [which also provide dental care], because now our patients couldn’t go and get coverage or care, then have their insurance provide the health center with reimbursement for their oral health.