A Nashville judge issued a restraining order temporarily barring the Tennessee Department of Health from reporting the identities of hundreds of extremely ill and disabled immigrant children to a state immigration office.
The June 24 order was issued in response to a lawsuit filed the same day by three physicians. The action seeks to block a new law requiring “all identifying information” of sick children without legal status to the Tennessee Centralized Immigration Enforcement Division, a state agency created in 2025 to assist federal immigration enforcement operations.
Patricia Moskal
Davidson County Chancellor Patricia Head Moskal’s temporary restraining order stopped the law from going into effect July 1. She scheduled a court hearing in the case for the following day.
“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,” she explained in the order.
The physicians’ patients are among 400 immigrant children receiving treatment through Children’s Special Services, a federally funded program that provides acute care to severely ill children, including those with cancer, congenital heart disease and severe seizure disorders, according to the Tennessee Justice Center, which represents the plaintiffs in Snader v. Tennessee.
“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,” according to the action. “Either response results in irreparable harm for the plaintiffs and the patients they represent. CSS patients have indicated that they are fearful of disclosure of their identifying information.”
The lawsuit added that state health officials already have begun sending letters to immigrant parents informing them that continued treatment for their children is conditioned on disclosure of their immigrant status. “Some have already disenrolled from the program or are contemplating disenrolling because of the threat of the TDH disclosure, including children who have documentation but are in mixed-status families,” the complaint states.
Plaintiffs also contend Tennessee is violating federal guidelines because the Children’s Special Services program is partially funded through a health services block grant not subject to immigration status verification.
Michele Johnson
The action also accuses the state of not following proper procedures before sending notifications to parents because the health department is fundamentally unable to judge immigration status: “TDH cannot make consistent, accurate evaluations about whether patients are ‘legally in the United States’ because an individual’s noncitizen immigration status is often a complex, contested, open question of law and fact.”
The fact children’s lives are at stake should be a wake-up call about the new reporting requirement, said Michele Johnson, executive director of Tennessee Justice Center.
“For decades, Children’s Special Services has served as a lifeline for children with severe disabilities and chronic illnesses who have nowhere else to turn for care. This action threatens to disrupt care for some of Tennessee’s most medically vulnerable children,” she said. “When doctors are warning that even brief interruptions in treatment could be harmful or even deadly, we believe the state has a responsibility to protect these children rather than place them at greater risk.”