Tennessee's Republican government is putting an immigration checkpoint in front of HIV care.

In an October 1 memo, the Tennessee Department of Health told every agency that serves patients through the federal Ryan White HIV/AIDS program to rewrite its contract to require "eligibility verification for each potential beneficiary/recipient," the Tennessee Lookout reports. Under state law, that means proving you are lawfully in the United States.

On Monday, Nashville CARES, one of Tennessee's largest Ryan White providers, sued to stop it.

What Ryan White does

For more than 30 years, Ryan White has been the backbone of the federal government's response to HIV/AIDS. It pays for medical care, drug assistance, home health care, case management, help with health insurance premiums and hospice care for low-income people living with HIV.

The federal government doesn't require immigration checks for Ryan White or for its companion housing program for people with AIDS. Federal law specifically exempts the treatment of communicable diseases from immigration status checks, even as the Trump administration has worked to shut immigrants out of other public benefits.

The state tried once, backed off, then went bigger

This is Tennessee's second try. In August, the health department sent providers a memo saying that "effective immediately," no patient without documentation of citizenship or legal residency could be newly enrolled in many Ryan White and AIDS housing services. Nashville CARES filed a challenge, and the department withdrew the memo days later.

Then it came back with something broader. The October memo applies to every agency serving Ryan White patients, and it rests on a Tennessee law requiring that anyone seeking federal, state or local benefits prove they are lawfully present.

That law got sharper teeth this year. Tennessee Republicans passed a bill that adds criminal penalties for social service and public health workers who fail to verify status, and requires agencies to report people without legal status to the state's new immigration enforcement office. Agencies that don't comply could face an investigation by the state attorney general and lose state funding. Its sponsor, Republican Rep. Dennis Powers, said immigrants without legal status must be excluded from all state-funded benefits: "We welcome legal immigrants, but if they come here illegally, then they need to go back."

Who gets hurt

The lawsuit says the new contract language "threatens access to medically necessary HIV-related services for otherwise eligible low-income individuals." It warns that "individuals who lose access to those services face increased risk of worsening HIV disease, transmission of HIV, progression to AIDS and other serious health consequences."

At Nashville CARES alone, the lawsuit counts:

• at least 129 people with HIV who get help paying for health insurance
• 150 to 160 people whose mental health and medication management care it pays for
• 80 to 100 people who get health care at its clinics

The lawsuit says the contract language may or may not reach core Ryan White services like medical treatment and medications, since the state law the department cites refers to federal exclusions for those. Even so, it puts the help with insurance premiums — which is how many patients get care at all — at risk for anyone who can't prove citizenship or legal status.

And it isn't only immigrants. The lawsuit says U.S. citizens who can't produce the right documents could lose help too.

The Tennessee Department of Health didn't respond to the Lookout's request for comment about the lawsuit, and hasn't answered its questions about how many patients are affected.

Not the first time

This is the second lawsuit this year over Tennessee's health department putting immigration checks into safety-net health programs. In July, the department agreed to pause a policy requiring that sick and disabled children be reported to the state's immigration enforcement office while doctors challenge it in court. About 400 children with chronic and, in some cases, terminal illnesses stayed enrolled in the state's Children's Special Services program as a result.

What the record shows

Tennessee's health department is requiring every agency in the federal Ryan White HIV/AIDS program to verify patients' immigration status, backed by a state law Republicans toughened this year with criminal penalties for health workers. Federal law exempts the treatment of contagious diseases from these checks. At one Nashville provider alone, hundreds of people with HIV, including U.S. citizens without the right papers, could lose help paying for insurance, medication and care.

Source

Lawsuit: Tennessee to impose immigration checks in HIV/AIDS safety-net program — Tennessee Lookout