‘Panic is for wimps': What do Trump's funding cuts mean for Boston hospitals?

Boston Globe

11-07-2025

The following is a lightly edited transcript of the July 10 episode of the 'Say More' podcast.
Shirley Leung:
I'm Shirley Leung. Welcome to 'Say More.'
It's a uniquely challenging time for our nation's medical community. The Trump administration has set its sights on slashing federal funding for healthcare and research by tens of billions of dollars, which could be catastrophic for the National Institute of Health (NIH) and Centers for Disease Control and Prevention (CDC) funding is tenuous to say the least.
Then there's mounting political pressure to restrict access to care for low income families on Medicaid plus care for at-risk health groups like transgender Americans and immigrants. So how are healthcare leaders navigating these uncertain times? Today we're bringing you a live episode recorded at the Boston Globe's Health Equity Summit.
It was held in May at Cambridge's Sanofi headquarters. It's a conversation with Dr. Kevin Churchwell, CEO of Boston Children's Hospital. We discuss how major changes at the federal level are impacting healthcare workers and patient care in Boston, and beyond.
Okay. Here's the show:
Dr. Churchwell, thank you for being on 'Say More.'
Kevin Churchwell:
It's a pleasure to be here.
Leung:
So, Dr. Churchwell, can you tell me about that moment when you realized your year wouldn't go as planned?
Churchwell:
I think it's been my decade.
So, usually that moment happens on a Friday, at about four o'clock when there is an announcement about reducing the facility's administrative rate for NIH funding to 15 percent.
And you could imagine the amount of angst and just a bit of panic that occurred when that was announced. I tell my team, my phrase is 'panic is for wimps.'
In pediatric critical care, you just can't panic in an environment like that. And so taking that was our mantra.
We basically then said, 'Okay, what's the next step? What is going to happen? What does this really mean?'
And it took a period of time. It takes that weekend to understand it and to understand what will be the next step in terms of things go to court, things get stopped, and then how do we deal with that moving forward.
Leung:
So when you heard about this 15 percent cap, how much funding is at risk then at Boston Children's?
Churchwell:
So, the first calculations for us would be, each year we would lose about $80 million.
As you can imagine, you just can't find that on the street. And that would change just existentially what we can do in research, if that would go through from that standpoint.
Leung:
Can you talk about specific projects that won't get done if these cuts stick?
Churchwell:
Well, it's just not the projects that are happening now, but the new projects or the new opportunities that are just being held up right now. You know, research is not just about the present, it's about the future.
And what we do at Boston Children's is continue to support that present future by finding and supporting the next investigators that have great ideas, that are looking at particular mechanisms of how sales work, diseases, et cetera.
What that funding does is support those individuals to start that work that ultimately leads to treatments and cures. Ultimately, it leads to what we were talking about outside in terms of what's happening with the care of the individual with Cystic Fibrosis or the care of the individual with sickle cell disease.
Leung:
Can you talk about, just in your career, the progress made in terms of treating Cystic Fibrosis and if you could explain what the disease does and how it affects children.
Churchwell:
Absolutely. Cystic Fibrosis is a problem in how cells really process sodium and potassium electrolytes. That leads to a problem in how lungs clears mucus.
As an example, it also leads to how the pancreas works and et cetera. It's a disease that for a long period of time, had a mortality.
And what I mean by that is that the kids who had the disease knew that at some point in their life they were going to die prematurely. And so they really developed their life based upon that for a period of time, they would die in adolescence.
We got better in terms of the treatment, and these children would sort of then have a life in their twenties and their thirties, but still, they knew that at some point their life was going to stop.
Leung:
It was a hard life too, right?
Churchwell:
It's a tough life every two weeks, every four weeks back in the hospital.
With the research that occurred, first understanding the fundamental mechanisms of how cells work, ion transport, understanding the genetic defect in the disease, and then asking the question, 'Can we actually affect that defect?'
You were talking 30 years of work, 20 to 30 years of work, which ultimately led to the development of drugs. There's a three-drug cocktail that 90 percent of the kids with Cystic Fibrosis can take, that has totally changed their life.
It's phenomenal what we've seen, and it's due to that discovery that's occurred.
Leung:
And a lot of it was federal funding, right?
Churchwell:
Federal funding, plus foundation funding and Joe O'Donnell's work with Cystic Fibrosis locally here. It's just incredible work. It took a lot of dollars that needed to really fund that sort of understanding of the mechanisms and then the drug development.
That was the relationship that we've had, this partnership with the federal government for 80 years, which has led to incredible discoveries across the board of medicine on all parts of science.
Leung:
You mentioned earlier that federal dollars support research, support the future. So when those dollars are cut, what are you most worried about that won't get done?
Churchwell:
I'm worried about who we will not be able to support these individuals who have these great ideas.
And I'm worried about how they will decide, 'I don't think I'll go into medicine or biological research. I think I'll be a computer scientist because that's where the money is.'
These are brilliant individuals. They could probably do anything they want in life. These individuals, if we can support them, change the world, change individuals, change our children and give them a real future.
And that's what I worry about.
Leung:
I want to ask about a specific Boston Children's program.
It's the first pediatric and adolescent transgender health program in the country. President Trump, through a series of executive orders, has stripped away many rights of trans and non-binary individuals, including defunding gender affirming care for youth.
Even before Trump was elected, there were some questions about paying for this type of care. And now he's really doubled down with threats of withholding federal funds and other penalties. So do these headwinds make Boston Children's rethink how you provide care to these patients?
Churchwell:
They've not created an environment where we're rethinking.
We are totally committed to the care of all of our kids and the goal of any pediatric hospital, especially Boston Children's Hospital, is to work to create the best future for that child, so our gender affirming care program is a great example of that.
The important part that I would stress to everyone is that these kids have a real issue that they're grappling with, that is affecting their life from a medical, physical, and mental standpoint.
And our ability to intercede and support them has been transformative for that child, for that adolescent, for that young adult that they can see a future for themselves. And so our commitment to that is straightforward, has not wavered, and we have committed our support to our gender-affirming care program.
In that regard, I will tell you that our state leaders have been incredibly supportive. Our governor has been incredibly supportive. Our attorney general has been incredibly supportive of the work that we're doing because it's work that really supports that individual child, that family. And so we continue that work because we know that there are headwinds.
And, we've seen this across the country. A little known fact is that, we see a lot of kids, families from other states now because they can't get care in their state, so they're coming to us, in that regard.
There will be, and there are going to be, challenges moving forward. We're trying to be very smart about it. We're working to make sure we're supporting our caregivers in that regard, in the care and in the work that they're doing.
Leung:
Do you depend on any federal funding or government funding for this type of care? What do you do if that funding disappears?
Churchwell:
Right now, the support and care of those kids really comes from either commercial insurance or Medicaid. And that's where the rubber may meet the road there, in terms of decisions made about Medicaid funding or how the commercial payers decide about that support
Leung:
As a black doctor and now the hospital's CEO, you've long championed health equity. If DEI programs are to be rolled back, do you think they will be hard to re-implement?
Churchwell:
That's an important question. I've never seen DEI as some separate thing. It's a separate program that sort of sits out there, as opposed to integrating it into what we do every day.
And that's always been my goal and that's what I've always tried to help lead in terms of what we've put in place. And so given that, we will continue to do the work that we have done, in terms of providing an environment where every child gets the best opportunity for care that they can receive at our hospital.
Part of that is the work that we've done in diversity, equity, inclusion, and you can call it another name. Whatever you want to call it, it's integrated in what we do, and it's for every child.
To me, the discussion kind of gets lost when the discussion tries to pit it as something that's different or wrong, as opposed to, 'No, it's the ability for us as a society, us as a children's hospital to provide the best care. The most optimal care for every child that we see.'
Now, what does that mean in reality terms? Well, we work to try to understand where the child and the family are coming from. And in doing that, we're better able to actually provide care for the child, who they interact with, how the interaction occurs, how we are viewed from their standpoint.
You know, if you walk into our children's hospital and you stand in the lobby, it's always a great thing. I always encourage everybody to do that because what you'll see is the United Nations. You'll see everybody from all parts of Boston, the New England region, and all over the world.
So the question is, given that, how can we best provide the most excellent care if we don't reflect who they are and we're able to pull from the entire range of talent that's out there? And so that's what we're trying to do and that's how we've integrated it into what we do. That's how I view it. We'll continue to move forward.
Leung:
So in higher education, we're seeing some presidents, like at Harvard University and Princeton University, stand up to the Trump administration over proposed funding cuts. Do you see hospital CEOs doing the same thing?
Churchwell:
Yes. I'll say that we believe in what we are doing and the importance of it.
The issues that our colleagues are facing, our brethren are facing in the university setting, those issues are profoundly important and what Harvard has done is so important, and it is going to be that question that has to be answered, in terms of the ability for universities to teach and to educate in a way that is across the spectrum.
It has never been the question for me who's right and who's wrong, that you shouldn't talk or they shouldn't talk. Everyone should be able to talk of course, and present views and have the discussion because that's how we learn. That's how we were able to move things forward. And to preserve that ability for our universities to do that, I think is profoundly important.
Leung:
At Children's, we think of you as seeing patients, the clinical side, but you also do a lot of research. Often you work with the universities, too. Your fates are kind of tied together.
So I was just wondering if you could talk about when we read about what's happening at Harvard or Massachusetts Institute of Technology (MIT) there are layoffs, they're pausing research, there's a hiring freeze.
What is happening at Boston Children's Hospital? Have you had to do any of that?
Churchwell:
What we've done is take a very measured approach around what's happening.
We have paused what we call our 'capital projects.' These are major projects that run into the 500 million range because they are associated with what we call our 'planning exercise,' a 10-year capital plan with the assumptions that we've made, that have been very consistent about where dollars would come from, like from the federal government, so that we can move forward.
So what has been created is an incredible instability. You can't plan right now. I've told our folks, our board, that I think the next six to eight months will clear that fog. We call it a 'fog,' in terms of the rules of the road here. And given that, we will then figure out how we can move forward.
But right now we've paused those major things. We've paused any major recruitments. We've also really maintained that those that are part of Boston Children's Hospital, we are supporting, especially our research community. How do we bridge them, as we get through this fog that we're dealing with right now?
Leung:
When we were talking earlier, you said you have about 14,000 to 15,000 employees, right? At Children's, it's quite a big enterprise, between clinical and research, so anxiety must be really high among your employees right now?
Churchwell:
Yes.
Shirley:
How do you talk to them? What do you say to them during these uncertain times?
Churchwell:
Well, we talk a lot and we try to do it in multiple forums to try to answer their questions. We've tried to be very transparent. Every third answer is, 'I don't know. I can't give you an answer.'
But, that's okay. It's more the ability for them to ask the question and to actually know that we're thinking about it. What our promise to them is that we will continue to follow up and continue to have that dialogue.
And so we are doing that on a regular basis in as many forms as we can: email, town halls, Zoom, and et cetera to try to keep everybody up to date and try to let everyone know where we are and what's going on as we go through this.
Leung:
Is it like another pandemic for you?
Churchwell:
It's like the pandemic. It's kind of like Groundhog Day. I thought I was not gonna hear Sonny & Cher, but I keep hearing Sonny & Cher.
Leung:
This has been a heavy conversation. It's been like this all day long at the Health Equity Summit. So I was just wondering, in light of everything that is going on, what gives you hope during this time?
Churchwell:
Let's all remember the arc of justice, and let's remember that we live in a country that has a phenomenal history, but an important history.
It's never been just roses and incarnations. The work to continue to move forward has been important work, difficult work, but work that we all are committed to continue to move us forward as a country.
My mom was born in 1931. My dad was born in 1917, so my dad went through two world wars.
He was born at the end of World War I, he went through World War II and I, and I'll tell you, he didn't volunteer. He then started his work as a newspaper man at a daily southern newspaper.
Leung:
I didn't know that. You buried the lead.
Churchwell:
I buried the lead. He's actually in the Smithsonian Institution.
So looking back on their life, what they went through, I missed it. I missed it just by a few years in terms of colored bathrooms. Now I have brothers that are eight years older than I am, and they went through it. And so just to appreciate the arc of our country.
It's never been easy. It's been hard. You keep moving forward and I think that we have to continue to keep moving forward in this piece of work.
Leung:
Dr. Churchwell is the CEO of Boston Children's Hospital. Thanks for joining us on 'Say More.'
Listen to more 'Say More' episodes at
Kara Mihm of the Globe staff contributed to this report.
Shirley Leung is a Business columnist. She can be reached at