Tennessee Health Dept. threatened to report disabled immigrant children to state immigration-enforcement division

The Tennessee Department of Health, under Interim Commissioner John Dunn, sent letters dated June 1, 2026, to roughly 400 families enrolled in the Children's Special Services program, a last-resort public health insurance program that has served Tennessee children regardless of immigration status for decades. The program covers low-income children with disabilities, ventilator dependence, and life-threatening illnesses such as cancer, spina bifida, and congestive heart disease.

The letters warned that if a family kept its child enrolled in the program after June 30, 2026, the department would share the child's immigration status with the Tennessee Department of Safety and Homeland Security's Centralized Immigration Enforcement Division, which shares data with U.S. Immigration and Customs Enforcement. The department cited a 2026 state law, signed by Gov. Bill Lee, requiring immigration-status verification for applicants to public benefits — but the law's text limits that requirement to applicants age 18 or older, a distinction pediatricians, legal advocates at the Tennessee Justice Center, and even a former deputy state health commissioner said the department misapplied to children.

Pediatricians and providers, including Nashville-based nonprofit Siloam Health, said the directive forced parents to choose between their children's life-sustaining medical care and the risk of a family member being reported to immigration enforcement. The Metro Nashville Public Health Department said the letters would reach at least 90 families in Nashville alone, with more expected as additional case files were reviewed statewide. The department did not offer an alternative-care transition plan for children who might be dropped from the program.

Updates

2026-06-24 — Nashville judge issued temporary restraining order blocking the data-sharing [5, 6]

A Davidson County chancellor issued a temporary restraining order barring the Tennessee Department of Health from sharing the children's immigration information with the state's Centralized Immigration Enforcement Division, hours after the Tennessee Justice Center filed suit on behalf of three Nashville physicians whose patients included children with epilepsy, congenital heart disease, cerebral palsy, and leukemia. A hearing on a longer-term injunction was set for July 2, 2026.

2026-07-14 — State agreed to halt reporting under an agreed temporary injunction [7, 8]

On July 14, 2026, the Tennessee Department of Health entered an agreed temporary injunction in Davidson County Chancery Court, agreeing not to report roughly 400 immigrant children enrolled in Children's Special Services to the state's Centralized Immigration Enforcement Division while the Tennessee Justice Center's legal challenge proceeds. Under the agreement the department also agreed to restore enrollment for families who had been told to disenroll, to recertify affected families annually regardless of immigration status, and to notify parents and providers of the injunction in each family's primary language.