Tennessee Today, AfD Tomorrow

Tennessee is tying a support program for severely ill and disabled children to the threat of sharing their data with an immigration authority. This is not some distant American exception. A motion by AfD in the German Bundestag seeks the same for Germany, placing medical care in the hands of immigration authorities, and anyone seeking treatment would have to surrender their data to them.

The administration of Governor Bill Lee is tying a medical program for sick and disabled children to the threat of reporting their information to an immigration authority. Families whose children depend on Tennessee’s Children’s Special Services program learned last week that information about their child could be shared with the Department of Safety and Homeland Security if the program continued paying for care beyond June 30. That department contains the state’s central immigration enforcement office, which works together with ICE.

The notice reached around four hundred families whose children do not have permanent status, many of them severely ill. Some depend on feeding tubes and ventilators, require special nutrition and medication, care that cannot be replaced by a quick transition or an emergency room. The choice being left to them is not really a choice at all: continue care and risk immigration enforcement, or leave the program and lose the support that keeps their child stable. Children’s Special Services is a long standing public program for children with disabilities and chronic illness, some with terminal diagnoses. It supports uninsured and underinsured children and pays for what families cannot manage on their own, from clinics and specialists to medication and in home assistance. More than forty six hundred children are enrolled. The threat affects the smaller group without permanent status, and the damage is not distant. It falls on families already struggling with severe illness and living with the fear that every interaction with the state could expose them.

Gabriella’s ten year old son has complex medical needs and has relied on Children’s Special Services for years. Her family said they will withdraw him from the program because they fear being reported to immigration authorities.

Among the affected families is Gabriella’s, who wanted to be identified only by her first name out of fear that immigration authorities could target her family. Her asylum application is still pending. Her ten year old son is seriously ill. He has spina bifida and autism, as well as kidney disease, uses a wheelchair, and has depended on the program for seven years. After receiving the notice, Gabriella and her husband decided to withdraw him. The decision came out of fear. Fear that continued care would expose the family to authorities and that detention would interrupt their son’s treatment, and above all fear that the system asking for their child’s information would become the same system separating him from those keeping him alive. She said she did not want immigration authorities coming to her door and taking her into custody because her son would receive no care in detention. Later she explained through a translation app what she wanted people to understand. These are innocent children, it said.

The children affected by this decision are not immigration talking points. They are children with kidney disease and cancer, with disabilities, and parents trying to protect them.

The notice cites a new Tennessee law which, according to the health department’s interpretation, requires reporting immigrants without permanent status who receive public benefits. Attorneys representing low income patients dispute that interpretation and argue the law applies only to adults. Tennessee Justice Center, a nonprofit legal organization, searched for families willing to support a lawsuit and by Friday had found none. The families are afraid, says director Michele Johnson, because even if their names did not appear fully in public records, they would still have to be disclosed to the state’s attorneys during litigation. That is how pressure works even before raids or detention begin. It makes families too afraid to seek help or challenge the state. Care workers are now trying to prevent children from losing treatment. Nurses searched for ventilators, feeding supplies, and specialized nutrition to keep children alive, reports Morgan McDonald of Nashville’s Health Council. They are working around the clock, but resources are becoming scarce. The Republican sponsor of the law referred families to emergency rooms, saying emergency and lifesaving treatment would remain protected. But an emergency room only treats emergencies. It cannot replace continuous specialist care or feeding supplies, neither ventilation nor treatment for kidney disease nor in home support that keeps a seriously ill child stable before a crisis becomes an emergency.

Gabriella put it simply. Her son needs therapies and doctors the family cannot afford, and the emergency room does not provide what fills his room: catheters and diapers, medication for kidney disease and infections, leg braces, and the equipment that lifts him out of bed. Her husband pays taxes, she said. They want to take nothing from anyone. They only want to help their son, as any parent would. Tennessee’s Department of Health did not respond to repeated requests. Even State Senator Heidi Campbell, a Democrat from Nashville, was denied information because of possible litigation. Legislators have both the right and the obligation to know, Campbell said, whether agencies are acting within their authority, especially because four hundred severely ill children may be subject to reporting beyond what the law requires. The silence adds another layer of harm because families must make urgent decisions while the state conceals how and when it shares children’s data and whether any protection remains.

How closely a letter from the health department resembles a threat can be seen in this family’s changed life. Since raids in Nashville led to more than one hundred arrests, Gabriella and her husband usually drive separately so their children would not lose both parents if one ended up detained. They only travel together on Sundays to church. Every day when her husband leaves for work, they hug and pray for his safe return. Enforcement no longer needs to enter a house in order to have an effect. It reaches through an envelope from the health department, through a deadline and a form, and causes families to disappear from care before the state ever has to remove anyone. June thirtieth is not an administrative date. It is a cliff, and for a child in chemotherapy, attached to a feeding tube or ventilator, such a day can shake the entire plan of care.

Anyone who sees this as distant American harshness should read a motion that has been sitting in the German Bundestag since September 2025. Under number 21/1750, the AfD parliamentary group, introduced by members Martin Sichert, Christina Baum, and Carina Schießl together with additional members and signed by Alice Weidel and Tino Chrupalla, demands limiting migration into the healthcare system and reducing medical care for foreigners to the constitutional minimum, modeled after Denmark.

According to current law, the motion argues, asylum seekers receive benefits extending beyond emergency care, including treatment of chronic illness and psychotherapy, and after eighteen months, since 2023 after thirty six, in many cases the same services as statutory insurance recipients. This generous interpretation creates false incentives and invites abuse of the asylum system. The motion cites current Chancellor Friedrich Merz, who said people become furious when they see rejected asylum seekers receiving full medical benefits and getting dental work while citizens next door cannot get appointments.

Within six months, the government should present legislation limiting benefits to the indispensable minimum under Article 1 and Article 2 of the Basic Law. Support under Section 4 of the Asylum Seekers Benefits Act would then be limited to acute emergencies and pain treatment, along with procedures that cannot be postponed. Discretionary benefits under Section 6 for chronic illness and dental care, prenatal care, vaccinations, and psychotherapy would be abolished unless an oversight authority decided otherwise in individual cases. Rejected asylum seekers and people without clarified status would receive emergency care only, and anyone who had not worked before applying and showed no willingness to do so would lose social benefits and receive emergency treatment only. The justification given is human dignity and the right to life. Anything beyond that is described as not constitutionally required, an incentive for migration, and state welfare should not become substitute infrastructure for immigration.

Cases are rising in Germany as well

Read also our article: Bagrat may stay and will not be deported - A boy who can sing forced Germany to make a decision

This is where the motion connects with Tennessee.

It requires authorization for every further treatment and centralizes initial care in state controlled reception facilities, but ultimately authority would rest with immigration offices, which would take control of the entire system of care. An office that must approve treatment first requires information, otherwise it cannot decide, and for it to decide, the patient’s data must be transferred to it. Care in the hands of immigration authorities keeps the medical file and the immigration file in the same drawer. What Tennessee achieves through an envelope, this proposal would build into the structure of government itself: anyone who wants treatment must become known to the office deciding whether they may remain. The examination room would become an extension of the authority.

Between Tennessee and Berlin lies an ocean and the same idea, tying care to disclosure. Whether through an American letter or a German authorization, the patient is meant to choose between treatment and security. The proposal calls itself humane and moderate, yet a concept of dignity that begins by handing patient data to the authority capable of deporting them has already made its decision about the person. Anyone who wants to know what this would look like under AfD governance does not need to look toward Tennessee. The motion exists in print. And the children, there and here, did not create the emergency. They are only the ones made to carry it.

The AfD’s reasoning in Bundestag document 21/1750, which makes any further commentary unnecessary.

To be continued ...