It began with little fanfare. No news conference, no hearings in Congress, no proposed rule or executive order published in the Federal Register for public comment. Indeed, no announcement whatsoever came from the White House.

Within the past several weeks, immigrant families with extremely ill children – children with cancer, muscular dystrophy, cystic fibrosis, heart disease, HIV, and other life-threatening ailments – began receiving terse letters from the federal government.

The letters informed them that their application to stay in the U.S. under what is known as “medical deferred action” had been denied, and they had 33 days to leave the country, meaning their children would have to forgo additional medical treatment. To add insult to injury, a number of these letters landed in their recipients’ mailboxes midway through the 33-day grace period.

USCIS recently made changes stripping certain immigrants getting medical treatment of deferred action. Here’s what the notice going out to these immigrants says: pic.twitter.com/8auJSSL4dN

— Steph Solis (@stephmsolis) August 26, 2019

News of the letters began to surface on Monday of this week, when three media outlets – CommonWealth Magazine, followed by the Boston Globe and public radio station WBUR of Boston —  reported on the letters, which had been received by Boston-area immigrant families with children who were being treated at Boston Children’s Hospital, long considered one of the leading pediatric hospitals in the U.S. By Tuesday, the Miami Herald had picked up the story after it found several families in the Miami area who had received similar letters. By then, MSNBC’s Rachel Maddow was all over the story, including this 18-minute broadcast.

The family of 16-year-old Jonathan Sanchez, a Honduran boy who has been getting treatment for cystic fibrosis in Boston over the past three years, is among those who have been ordered to leave. He tearfully told WBUR, “If they deny the program, then I’ll need to go back to my country. I will probably die, because in my country there is no treatment for CF (cystic fibrosis).”

Samuel Costa, who comes from a remote village in Brazil, is three years old. He suffers from a rare disease that prevents his body from processing nutrients. He is being treated at Boston Children’s Hospital, where practitioners inserted a tube into his stomach, which is how he is fed. “If he has to move to Brazil, that’s it,” his mother said – meaning he will die.

After helping break the news, the Boston Globe had this to say in an editorial headlined “Can the Trump Administration sink any lower than threatening to deport sick kids:”

“Step by malicious step, the Trump Administration is turning the American immigration system into an apparatus of appalling, intentional cruelty.

“The latest case in point is a relatively small program known as ‘medical deferred action,’  in which immigrants without legal status who are suffering from serious medical conditions are granted a reprieve from deportation so that they can have access to much-needed medical treatment in the United States.

“Trump halted the program this month, threatening to deport these patients, including children with leukemia, muscular dystrophy, or cystic fibrosis. The program’s termination means suspending or interrupting medical care, which in some instances is virtually a death sentence.”

Sen. Ed Markey (D-MA) held a news conference outside an immigration center in Boston. “It is unconscionable, it is just wrong…we have now reached the most inhumane of all of Trump’s policies…The Trump Administration is now literally deporting kids with cancer.”

A powerful call to action from @SenMarkey to ALL Americans to fight to save the critically ill patients whom this administration wants to deport to their deaths. Not now, not ever! pic.twitter.com/oAGKCvArli

— MIRA Coalition (@MIRACoalition) August 26, 2019

So one might wonder: what is the Trump Administration saying about all of this – about a new policy it never actually announced? Well, a whole lot of finger-pointing is going on.

WBUR asked the U.S. Citizenship and Immigration Services (USCIS), the agency that sent the letters, three times for comment. On the third time, they got this response from an agency spokeswoman: medical deferred action requests are now being submitted to Immigration and Customs Enforcement (ICE) for processing.

Thing is…no one told ICE.

When the Miami Herald contacted ICE for comment, they received a version of, “USCIS said what???”

The newspaper reported:

“Three officials with ICE, who asked not to be named due to fears of speaking outside official channels, told the Miami Herald that the agency was blindsided by the move from USCIS. High-level sources said that management at the agency ‘had no idea’ USCIS was transferring over deferred action responsibility, noting that ranking officials were scrambling to respond to the unexpected move.”

WBUR put it more succinctly in a headline on its website: “Feds can’t agree on which agency – if any – handles medical deportation deferrals.”

“ICE is not going to implement any sort of a program or procedure or policy to take over that function,” an ICE official said, according to WBUR. “We’d like USCIS to clarify what they mean.”

“ICE does not have a program for this nor do we plan to,” another, unnamed ICE official told NBC News.

There’s more.

CommonWealth Magazine, which has been out front on a number of immigration-related stories, reported that representatives of USCIS and ICE sat down for the first time Wednesday morning to discuss the medical deferral policy. The magazine on Wednesday tweeted:

“ICE and USCIS officials allegedly had a meeting for the first time about this *this morning.* It’s going to be a collaborative effort moving forward, but ICE is 100 percent punting this back to USCIS.”

Meanwhile, lawyers who represent the targeted immigrant families are unsure how to proceed. One of these lawyers is Mahsa Khanbabai, who chairs the New England chapter of the American Immigration Lawyers Association. She has a client, a 14-year-old girl with a serious heart condition, whose family has received one of the USCIS letters. Her client is between heart surgeries – she is recovering from one surgery and is scheduled for another.

“Our government should focus its limited resources on truly dangerous people, not the most vulnerable,” Khanbabai told Rachel Maddow. She adds that the possible end of medical deferrals, and the resulting chaos and confusion, is consistent with the Trump Administration’s determination to find new and innovative ways to be cruel to immigrants.

“I think they didn’t care to put a plan in place to help these desperate and vulnerable people,” she said.