A Tennessee congressman is pressing Gov. Bill Lee to rescind a state directive that would require health officials to report approximately 400 sick or disabled children enrolled in the Children’s Special Services program to the state’s immigration enforcement division.
U.S. Rep. Steve Cohen, a Memphis Democrat, sent a letter to Lee on Wednesday urging the governor to pull back the directive before a June 30 deadline, after which the Tennessee Department of Health warned immigrant families their children would be referred to the Centralized Immigration Enforcement Bureau if they continued receiving services.
Why It Matters
The Children’s Special Services program provides care to low-income Tennessee children from birth to age 21 who have disabilities or serious illnesses. The program has served children regardless of immigration status since the 1930s, and more than 4,600 Tennessee children received services through it in 2024. The directive puts hundreds of those families in a position of choosing between medical care and potential immigration consequences.
What Happened
The Tennessee Department of Health notified immigrant families that children would be reported to the state’s Centralized Immigration Enforcement Bureau after June 30 if services continued. The directive stems from a recently enacted Tennessee law requiring immigration status verification for applicants for public services.
Cohen, in his letter to Lee, described the directive as “morally repulsive” and “inhumane,” and raised a substantive legal challenge: the legislation’s text restricts the verification requirement to applicants “18 years of age or older.” Cohen questioned whether the state has any legal basis to apply the reporting requirement to children 17 and younger.
The governor’s office has not publicly responded to the letter.
By the Numbers
- ~400 — sick or disabled children flagged for potential reporting under the directive
- 4,600+ — Tennessee children who received Children’s Special Services benefits in 2024
- June 30 — state-imposed deadline for compliance or referral to immigration enforcement
- 6 to 9 — young adults in the Nashville area already cut from the program after the state ended services for those aged 18 to 21 earlier this year
- Since the 1930s — the program has served children without regard to immigration status
Zoom Out
Tennessee is among a growing number of states that have moved to tie access to public services to immigration status verification in the wake of renewed federal emphasis on interior enforcement. Tennessee’s law represents one of the more expansive state-level efforts, though the apparent conflict between the statute’s text — which applies to adults 18 and older — and its application to minors could invite legal scrutiny.
Rep. Dennis Powers, a Jacksboro Republican who co-sponsored the underlying legislation, defended its application, stating: “No child receiving lifesaving medical treatment is denied care because of this new law.” Powers’ characterization differs from how the Department of Health notices have been interpreted by affected families and their advocates, who argue the threat of immigration referral itself constitutes a denial of access.
Cohen, who has represented his Memphis-area House district for 19 years, is retiring after Republican-led redistricting split the district. In his letter to Lee, he framed his appeal in personal terms, writing: “As you wind down your term of Governor, consider your Christian background as you implement policies that will define your legacy.”
What’s Next
The June 30 deadline leaves little time for administrative or legislative correction. Cohen’s letter calls on Lee to act unilaterally by revoking the directive. If the governor does not act, affected families will face the choice of withdrawing from the program or having their immigration status referred to the state enforcement bureau. Legal challenges based on the age restriction in the statute’s text remain a possibility, though no litigation has been announced.
The situation in Tennessee reflects broader tensions across multiple states as immigration enforcement intersects with longstanding health and disability programs. For more on Tennessee government and policy, see recent coverage of a federal corruption indictment involving a Shelby County clerk.