Panel Discussion on Challenges and Opportunities in Children’s Health Policy

On September 25th, the Schroeder Center for Health Policy hosted A Conversation About Children’s Health Policy, a panel discussion on the future of health care and wellbeing for Virginia’s youngest residents. Moderated by Dr. Elyas Bakhtiari, Associate Professor and Director of the Schroeder Center, the event brought together three experts whose perspectives spanned clinical practice, nonprofit leadership, and policy analysis.

The panelists included Jamia “Mia” Crockett, CEO of Families Forward Virginia and William & Mary ‘00 alumna; Dr. Mark Downey, a longtime pediatrician in Williamsburg and current candidate for the Virginia House of Delegates; and Freddy Mejia, Policy Director at the Commonwealth Institute for Fiscal Analysis. Together, they offered a discussion of the pressures facing families, the impact of recent state and federal policy changes, and possibilities for progress.

Each panelist began by highlighting what they saw as the most pressing challenges in children’s health. Dr. Downey noted the dramatic rise in demand for mental health services, explaining that the number of youth who need mental health care has tripled since he began practice. Anxiety, mood disorders, and ADHD have become increasingly common among his patients. Crockett discussed the importance of addressing families’ needs before they escalate into crises. Families Forward Virginia has found that access to basics such as a livable wage, healthy food, nearby medical facilities, and reliable transportation often makes the difference between stability and hardship. Mejia emphasized the importance of affordability, pointing out that Virginia’s eligibility threshold for the Children’s Health Insurance Program (CHIP) is significantly lower than the federal benchmark, leaving many families without affordable coverage. He also discussed barriers for undocumented children, who are disproportionately uninsured.

The conversation also spanned the recent changes in Medicaid policy. Over the summer, Virginia introduced new reporting requirements that obligate some Medicaid recipients to verify employment, schooling, or volunteer work every six months. Mejia and Crockett both cautioned that this system may impose steep administrative burdens on families and local social service offices that are already stretched thin. “The work requirements are just another bureaucratic burden for busy people,” Dr. Downey noted. The panelists also warned that these changes could have long-term financial consequences for rural hospitals and community health centers, which are likely to face shortfalls as fewer patients retain coverage.

Federal policy shifts also weighed heavily in the discussion, particularly changes to vaccination guidance and questions about the relationship between state and federal priorities. Dr. Downey emphasized that diseases “don’t stop at state lines,” raising concerns about states that roll back requirements. Crockett echoed the potential harm of weakening federal recommendations, while Mejia noted that Virginia has sought to align its regulations with those of the CDC and the American Academy of Pediatrics.

Despite the challenges, the panelists identified promising areas of progress. Dr. Downey pointed to expansions in mental health care access during the pandemic and new pilot programs to support childcare affordability through state-employer partnerships. Mejia mentioned recent investments in Black maternal and infant health, while Crockett pointed to family resource centers as critical tools for strengthening communities—though she stressed the need for renewed funding from the General Assembly.

During the Q&A, audience members asked about care models for the uninsured, the potential for schools to provide vaccines and basic health services, and ways to strengthen the state’s underdeveloped mental health infrastructure. The panelists emphasized that while solutions exist—from Medicaid reimbursements for school-based health services to investments in community clinics—they require sustained political will and resources.

By the end of the discussion, a central theme was clear: children’s health policy is closely tied to equity, access, and affordability. Crockett noted that families are more stable when their basic needs are met early, before problems escalate. The discussion emphasized the direct link between state and federal policy decisions and the conditions families face in their everyday lives across Virginia.