Undocumented Families in Tennessee Face Difficult Choice Over Child Healthcare Program

Undocumented families in Tennessee who rely on a state program to provide lifesaving healthcare for their severely ill or disabled child could be forced to disenroll from the program or risk their immigration status being reported to an immigration enforcement agency.

For years, low-income families in Tennessee have turned to the Children’s Special Services program for diagnostic tools, prescriptions, wheelchairs, hospitalizations, surgeries, therapies and more to support children with illnesses or physical disabilities. The program has served families regardless of immigration status.

But beginning July 1, children without legal immigration status enrolled in the program will be reported to the Tennessee Centralized Immigration Enforcement Division, an agency created last year to share data with Immigration and Customs Enforcement.

Parents without legal immigration status, who need the program for their child, must now decide whether the medical resources are worth risking ICE intervening and potentially deporting them.

The Independent has asked the Tennessee Department of Health for comment.

The change comes after the state passed a law requiring all state and local agencies, including health departments, to report the immigration status of people who receive benefits to the Centralized Immigration Enforcement Division.

While federal law prohibits undocumented immigrants from obtaining federal health benefits, each state has its own laws allowing immigrants to access state-funded programs.

But Tennessee joined four other states in passing laws that make state-level health agencies also immigration reporting agencies.

Doctors and immigration advocates have sounded the alarm on the ramifications of the new law.

Dr. Sanmi Areola, the director of the Metro Nashville Public Health Department, told the Tennessee Outlook earlier this month that he and his staff are “concerned and worried.”

“These are some of the kids with the highest health needs, and if they don’t have access to care or if they don’t have access to medications, conceptually no good outcome will come from that,” Areola told the news outlet.

Michele Johnson, the executive director of the Tennessee Justice Center, told NPR last week the new policy was “immoral” and “illegal.” She said they were preparing to sue.

Johnson said one client, who has a 10-year-old child with severe spina bifida, was already forced to disenroll from the program and delay a necessary pain-relieving surgery.

“I can't really imagine, as a mother, watching your child suffer, watching your child suffer not because of a serious illness that they're born with, but because the elected officials in your state want to have a political issue that they can run on,” Johnson told NPR.

Roughly 4,640 children were enrolled in the Children’s Special Services program as of 2024, the Tennessee Outlook reported.