MEMPHIS, Tenn. - In June, the Tennessee Department of Health sent letters to roughly 400 immigrant families whose children are enrolled in Children's Special Services, a state and federally funded safety-net program for children with serious disabilities and life-threatening illnesses. The letters gave those families a choice: leave the program by June 30, or have identifying information about their child turned over to the Tennessee Centralized Immigration Enforcement Division.

Children's Special Services serves more than 4,600 children statewide. Eligibility requires a serious chronic illness or disability. Congressman Steve Cohen, who represents Memphis, described the population in a letter to Governor Bill Lee as children with conditions including cerebral palsy, cystic fibrosis and sickle cell anemia, some of them in wheelchairs or on oxygen support.

Three Tennessee doctors who treat children in the program sued on June 24 in Davidson County Chancery Court, represented by the Tennessee Justice Center. Chancellor Patricia Head Moskal blocked the policy within hours of the filing, then extended the block while the parties negotiated. On July 14, an agreed order was filed under which the health department will not report these children to the immigration division and will not disenroll them while the challenge proceeds.

That is where the matter stands. The reporting has stopped. The directive has not been rescinded.

The Legal Dispute

The doctors' central argument is one of statutory reading. The new state law requiring immigration status verification for people receiving state and local government benefits applies, by its own text, to applicants 18 years of age or older. The plaintiffs contend the health department has extended a law written for adults to children.

Cohen made the same argument to the governor, writing that whatever his view of the policy's morality, the department's interpretation is not supported by a plain reading of the statute. Representative Dennis Powers, a Jacksboro Republican who cosponsored the legislation, said in response to questions about legislative intent that no child receiving lifesaving medical care should be affected.

The doctors also argue the reporting mandate conflicts with the rules governing the federal block grant that primarily funds the program, and that it endangers patients. Their filing states that for medically fragile children, disruption in care carries risk of suffering, injury and death.

The state's position, stated by a spokesperson for Governor Lee, is that Tennessee is required to administer Children's Special Services in accordance with applicable federal requirements and state law.

State Senator Ed Jackson of Jackson said in June that there had been discussion of the bill and that options for adjustment were being considered.

Why It Matters for Memphis

Memphis has one of the largest immigrant populations in Tennessee and a concentration of pediatric specialty care, including facilities that treat exactly the conditions Children's Special Services covers. The state health department has not published a county-level breakdown of the roughly 400 affected children, so the number in Shelby County is not publicly known. Nashville has been reported to account for about 90 of them.

The immediate stakes are narrow and severe. A family that disenrolled in June to avoid being reported did not get a court order restoring them. The agreed injunction protects children still in the program. The health department has not responded to questions about how many young adults were cut from the program.

The broader stake is the precedent. This is a state agency reading an adult-facing statute to reach children, in a program funded partly by a federal block grant, and pausing only under court order. Whether that reading survives will determine what other state benefit programs do with the same law.

Supporters of the underlying statute make a consistent argument: the legislature chose to restrict certain publicly funded services to citizens and lawful permanent residents, and an agency administering that law is following the legislature's instruction rather than making policy. The dispute is over whether the instruction reaches minors, and that is a question for the chancery court.

Accountability Watch

Who is accountable: The Tennessee Department of Health, which issued the directive. Governor Bill Lee, whose office has defended it as required by law. The General Assembly, which wrote the statute the department is interpreting.

What is pending: Whether the directive is rescinded or merely suspended, and how many families left the program before the court blocked it.

Timeline: Letters went to families in early June 2026 setting a June 30 deadline. Suit filed June 24. Temporary block issued the same day, extended July 2 and again to July 17. Agreed injunction filed July 14, 2026. No merits ruling has been identified.

Status as of July 29, 2026: Suspended, not withdrawn. The 901 Report has identified no rescission of the directive and no county-level disclosure of affected children.

How to verify: Davidson County Chancery Court records for the case filed June 24, 2026 by the Tennessee Justice Center on behalf of three physicians. Congressman Cohen's letter is published on cohen.house.gov. Ask the Tennessee Department of Health directly for the county distribution of the roughly 400 affected children and for the number of disenrollments recorded in June.