Congressman urges Gov. Bill Lee to revoke directive to report immigration status of sick kids

Tennessee U.S. Rep. Steve Cohen on Wednesday urged Gov. Bill Lee to revoke a state directive that requires the reporting of approximately 400 sick or disabled children enrolled in a public health program to a state immigration enforcement division.

In a letter to Lee, Cohen called the directive “morally repulsive” and “inhumane.”

“As you wind down your term of Governor, consider your Christian background as you implement policies that will define your legacy,” wrote Cohen, a Democrat, citing Biblical passages. Lee, a Republican, is in the last year of his second term in office.

The Tennessee Department of Health this month warned immigrant families with children in the Children’s Special Services program that they would be reported to the state’s Centralized Immigration Enforcement Bureau after June 30 if they continued to receive services. 

The directive has raised alarm among public health providers, child and patient advocates and the state’s pediatricians. The Tennessee Chapter of the American Academy of Pediatrics has urged the state’s pediatricians to send their own letters in opposition.

Providers scramble as Tennessee tells sick, disabled immigrant kids they will be reported

The Children’s Special Services program serves low-income children from birth to 21 who are uninsured or underinsured and have disabilities or disabling illness, including spina bifida, sickle cell anemia and other diseases. It serves children who are dependent on ventilators, oxygen and wheelchairs and helps families obtain specialist care and medical supplies, such as catheters, in-home oxygen and formula for children who are dependent on feeding tubes.

Funded by state and federal dollars, the program has served children regardless of immigration status since the 1930s. More than 4,600 Tennessee children in total received services through the program in 2024, according to the most recent publicly available data.

“Tennessee is required to administer the Children’s Special Services Program in accordance with applicable federal requirements and state law,” a  spokesperson for Lee wrote in an emailed response to questions from the Lookout. The Lookout’s questions included whether the governor plans to revoke the directive.

 On Wednesday, a spokesperson for the Department of Health responded to questions seeking more details about the notices — including the specific number of children impacted, the legal basis for its directive and whether any transition plans are in place for children in the middle of life-sustaining medical treatment who withdraw from the program as a result — with a copy of letters sent to parents and a 2025 “resource guide” for families.

The Department of Health ended services for young adults aged 18 to 21 in the program earlier this year, impacting between 6 and 9 individuals in the Nashville-area who could not provide proof of legal immigration status, according to Metro Nashville Public Health Department leaders. The state health department has not responded to a question seeking data on the total number of young adults cut from Children’s Special Services.

In his letter, Cohen also raised questions about the legal basis for the notices to families of children 17 and younger. The letter to parents cites recently-enacted Tennessee law requiring immigration status verification requirements for applicants for public services available through state and local government offices in Tennessee. The legislation also restricts these services to U.S. citizens or legal permanent residents.

Cohen cited a passage in the text of the legislation that restricted verification of immigration status for government services to those “18 years of age or older.”

Tennessee health department warns parents their children will be reported to immigration officials

“Notwithstanding my firm belief that targeting the most vulnerable, sick children and their parents for deportation — for an immigration matter in which the children did not seek out — is morally repulsive, I note the interpretation is not based on the plain reading of the text,” wrote Cohen, who is retiring this year after a GOP-led redistricting split in three the House district he has represented for 19 years.

Rep. Dennis Powers, a Jacksboro Republican who cosponsored the legislation, responded last week to questions about whether it was his intent for children to be impacted by the law with a statement that read:

“No child receiving lifesaving medical treatment is denied care because of this new law. Federal protections for emergency and lifesaving medical services remain fully in place regardless of immigration status, criminal status or insurance.”

The legislation, Powers said, “simply ensures taxpayer-funded public benefits are reserved for those who are legally eligible to receive them.” 

Advocates have pushed back against the notion that families of children with complex and chronic conditions can receive life-sustaining care in emergency rooms. 

U.S. Rep. Steve Cohen letter to Gov. Bill Lee