Judge issues restraining order in doctors’ challenge to TN plan to report disabled immigrant kids

A Nashville judge on Wednesday swiftly issued a temporary restraining order preventing the Tennessee Department of Health from turning over the names of about 400 disabled and critically ill kids to a state immigration agency that cooperates with federal immigration enforcement.

Davidson County Chancellor Patricia Head Moskal issued the order within hours of the filing of a lawsuit by three Tennessee physicians. The doctors are challenging the department’s notice to families that their child’s information will be shared with the Tennessee Centralized Immigration Enforcement Division after June 30 as a condition of of continued enrollment in a public safety-net healthcare program.

“It appears to the Court that Plaintiffs will suffer immediate and irreparable injury, loss, or damage before Defendants can be heard in opposition to the motion,” Moskal wrote in granting the motion before a hearing could take place. The judge set a July 2 court date in the case.

The lawsuit seeks an ongoing restraining order and injunction preventing state health officials from reporting the children’s immigration status while the case is litigated in court.

The doctors, represented by the public policy advocacy nonprofit and law firm, Tennessee Justice Center, argued the health department’s immigration reporting mandate poses grave harm to their young patients and is a misinterpretation of state law, preempted by federal law and is contrary to the “public good.” 

Absent immediate intervention, the doctors argued, their medically fragile patients will suffer irreparable harm or death as parents withdraw from the program rather than place their children and families at risk for being a target of immigration enforcement.

“The state’s new reporting requirement forces families to choose between foregoing such care or exposing themselves and their children to immigration enforcement, potentially resulting in detention or deportation action that would itself disrupt the child’s medical care,” the legal filing said.

Advocates for critically ill kids urge Lee to intervene before deadline to report immigration status

“For medically fragile children, any such disruptions will almost certainly cause suffering and injury, and potentially death,” it said. 

Dean Flener, a spokesperson for the state health department, did not respond to a request for comment on the lawsuit Wednesday. The department has not responded to a series of questions this month about the legal basis for their directive, the exact number of kids impacted and whether it has implemented any transition plans for children dependent on ventilators, oxygen or in the midst of chemotherapy if families are unwilling to risk their child being reported to immigration officials.

The state health department cited new Tennessee legislation in letters sent to families whose children are enrolled in the Children’s Special Services program. The letters warned families that information about their child will be turned over to the state’s immigration enforcement division after June 30 based on new Tennessee legislation. The letters were from the department’s interim chief John Dunn. 

Children’s Special Services is a publicly-funded safety-net public healthcare program for low-income children who are uninsured or underinsured. The program, by design, only serves children with disabilities who require ongoing medical interventions. More than 4,600 Tennessee kids, from birth to 17 years of age, are enrolled in the program, including the 400 affected immigrant children.

“A new law passed in this state, Public Chapter 1106, makes the Department of Health report all patients getting healthcare who are not legally in the United States…These reports will go to the immigration division in the Tennessee Department of Safety,” the letters said.

“If the Children’s Special Services program keeps paying for healthcare after June 30, 2026, the Tennessee Department of Health will share your children’s information to the Tennessee Department of Safety, as required by law,” they said.

The department houses the Centralized Immigration Enforcement Division, established last year by Republican lawmakers to foster collaboration between the state and Immigration and Customs Enforcement.

The lawsuit argues the health department has misinterpreted new state law requiring the reporting of immigrants without legal status who seek a broad range of state and federal public benefits. The law’s initial paragraphs say it is intended to apply only to applicants for public benefits who are over age 18. Language elsewhere in the legislation more broadly states that state and local agencies must report applicants who are not lawfully in the United States; public employees who fail to do so are subject to criminal prosecution. 

The lawsuit argues the over-18 language that appears in the initial passages of the legislation applies to its entirety. 

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

On Tuesday, the legislation’s Republican cosponsor, Sen. Ed Jackson of Jackson, Tenn., expressed reservations about its application to kids in the program. Jackson texted the Lookout that he was “looking into options to possibly adjust or make changes” to the legislation. 

The lawsuit also argues the state is violating federal rules tied to the funding of the Children’s Special Services program. The program is funded, in part, through the Maternal and Child Health Services block grant, which is not among the public benefit programs subject to the Trump administration’s 2025 requirements for immigration status verification, according to the lawsuit.

It also argues that the state health department failed to follow a state-mandated “rule-making process” before notifying families and questioned the department’s ability to accurately assess immigration status.

Parents of at least two chronically ill children who received the warning letters from the health department “are, in fact, ‘lawfully present in the United States,’” the lawsuit alleges.

The department “cannot make consistent, accurate evaluations about whether patients are ‘legally in the United States’ because an individual’s noncitizen’s immigration status is often a complex, contested, open question of law and fact.”

The lawsuit was filed by the Tennessee Justice Center on behalf of three Nashville-area physicians who treat patients in the children’s program: Dr. Brent Snader, Dr. Jule West, and Dr. Kristin Martel.

Their impacted patients include children who suffer from epilepsy, congenital heart disease requiring surgery, cerebral palsy, traumatic brain injury, and leukemia. They include kids on feeding tubes and ventilators currently paid for by the program. 

The lawsuit