with W. Cronkite, Editorial Director
NASHVILLE — The Tennessee Department of Health has agreed not to report approximately 400 critically ill and disabled children to immigration enforcement, reversing a policy that would have forced families in the state’s Children’s Special Services (CSS) program to choose between life-sustaining medical care and the risk of deportation.
The agreement — an “agreed temporary injunction” filed July 15 in Davidson County Chancery Court — binds the state until a trial or further court order. It arrived three weeks after three Nashville physicians sued to block the reporting policy, arguing it misinterpreted state law and threatened irreparable harm to medically fragile children.
Here is what the evidence shows:
1. The policy. In early June 2026, the Tennessee Department of Health sent letters to roughly 400 of the 4,600 families enrolled in CSS — a state and federally funded program serving children under 21 with serious conditions such as cancer, leukemia, Type 1 diabetes, muscular dystrophy, cerebral palsy, congenital heart disease, and seizure disorders. Families with incomes at or below 225% of the federal poverty level qualify. The letters, signed by interim Health Commissioner John Dunn, warned that continued participation would mean their identifying information would be forwarded to the Tennessee Centralized Immigration Enforcement Division, which coordinates with U.S. Immigration and Customs Enforcement (ICE). Families were given until June 30 to disenroll or be reported.
2. The legal challenge. On June 24, three physicians from Siloam Health — a Nashville community health center — filed suit in Davidson County Chancery Court, represented by the Tennessee Justice Center. They argued the Department of Health was misreading Public Chapter 1106, a new state law requiring agencies to verify immigration status and report individuals without legal status who receive public benefits. The law, the plaintiffs noted, specifies reporting for individuals 18 and over — not children. Some families with lawfully present children had also received warning letters due to what the suit called the state’s inaccurate status determinations. Chancellor Patricia Head Moskal granted a temporary restraining order that same day.
3. The agreement. Under the July 15 agreed injunction, the Department of Health may not report CSS participants to immigration enforcement; must restore and maintain enrollment for children enrolled as of June 1 regardless of immigration status; must continue annual recertification without regard to immigration status; and must notify affected families and medical providers of the injunction in each family’s primary language. The state did not admit wrongdoing by agreeing to the terms.
4. The stakes. “This agreement provides vital protections for families who should never have been forced to choose between their child’s healthcare and the fear of immigration enforcement,” said Michele Johnson, executive director of the Tennessee Justice Center, in a statement. “Children with complex medical needs deserve uninterrupted access to care.” The CSS program, which has operated for decades, provides care coordination and financial assistance for equipment, therapies, and specialty care. Physicians who filed the suit warned that disruption of care could cause declining health or even death for children whose conditions require consistent treatment.
The case is currently stayed pending a separate Petition for Declaratory Order filed with the Department of Health. No trial date has been set. The injunction remains in effect until a trial or until further order of the court.
The question that follows: If a state law was not intended to apply to children, how did it take a lawsuit and a judge’s order to stop the Department of Health from applying it that way?
