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KFF Health News and The Trace conducted a data analysis of how insurance status affects the care of gunshot wound victims.
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Alea Bates was shot seven times at close range in Tallahassee, Florida, in 2019.
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Alea Bates was working as an Uber Eats driver when she was shot.
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Alea Bates did not have health insurance at the time she was shot.
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Alea Bates was treated at Tallahassee Memorial HealthCare’s main hospital.
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Surgeons removed bullets and fragments from Alea Bates' body.
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Hospital records indicate that none of the bullets fired at Alea Bates damaged her internal organs.
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Alea Bates was discharged from the hospital four days after being shot.
Alea Bates, gunshot victim
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Alea Bates said she was unable to get out of bed or walk to the bathroom without help after surgery.
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Hospital records state that Alea Bates complained of intense pain radiating down her left leg, weakness in her knee, and a numbing sensation below it.
Alea Bates, gunshot victim
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Alea Bates said the hospital did not perform further X-rays, CTs, or MRIs to determine the cause of her knee numbness.
Alea Bates, gunshot victim
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Alea Bates said hospital staff told her the numbness would go away.
Alea Bates, gunshot victim
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Alea Bates said doctors stated she was medically stable.
Alea Bates, gunshot victim
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Alea Bates said she could not be sent to a rehabilitation hospital or skilled nursing facility because she lacked health insurance.
Alea Bates, gunshot victim
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Alea Bates said hospital staff indicated they needed the bed for a patient with insurance.
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Alea Bates incurred approximately $60,000 in medical bills from her hospital stay.
Alea Bates, gunshot victim
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Alea Bates said, "It's crazy that in this country somebody else can hurt you, and you have to pay for what they did to you."
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At least one firearm injury is treated in an American emergency room every 30 minutes.
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Tens of thousands of people die from firearm injuries in the U.S. every year.
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The Trace and KFF Health News analyzed data compiled by Florida hospitals to collect payments from insurance companies and file with the state.
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The data used in the analysis was obtained exclusively for this reporting, aided by Florida state law.
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The data analyzed by The Trace and KFF Health News did not identify patients.
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The data contained patients’ insurance status, residential ZIP code, race, and other demographic information.
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The analysis covered hospital billing data from 2018 to 2024 obtained from the Florida Agency for Health Care Administration.
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The analysis identified more than 20,000 gunshot wound hospitalizations in Florida.
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Uninsured patients comprised 25% of the more than 20,000 gunshot wound hospitalizations identified in the analysis.
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Uninsured patients were the largest single group treated for firearm injuries in the analyzed data.
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Uninsured gunshot victims in Florida had an average hospital stay of about six days.
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The average hospital stay for uninsured gunshot victims was three-quarters of the time spent by patients with private insurance.
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The average hospital stay for uninsured gunshot victims was less than half the average stay for patients on traditional Medicaid.
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Among the most severely injured patients, uninsured individuals stayed three fewer days in the hospital on average than insured patients.
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The gap in hospital stay duration persisted regardless of hospital size, location, or ownership type.
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The gap in hospital stay duration persisted at facilities that receive taxpayer money with a mandate to treat all patients regardless of ability to pay.
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Nearly half of the gunshot wound patients in the analyzed data were Black.
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About 25% of nonwhite gunshot wound patients were uninsured.
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Fewer than 20% of white gunshot wound patients were uninsured.
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Black people are more likely to become victims of firearm homicide than white people, according to the Johns Hopkins Bloomberg School of Public Health.
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Florida law allows eligible residents to carry a concealed firearm without a state-issued license.
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Florida law allows eligible residents to openly carry a firearm without a state-issued license.
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Florida state law prevents cities and counties from enacting stricter gun control measures.
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Florida Attorney General James Uthmeier argued that the three-day waiting period for purchasing a gun is unconstitutional.
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James Uthmeier’s request is part of a proposed settlement of a lawsuit brought by the National Rifle Association.
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Arch Mainous is a University of Florida professor and vice chair for research in community health and family medicine.
Arch Mainous, University of Florida professor
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Arch Mainous said there is evidence that financial incentives drive care for patients and hospitals.
Arch Mainous, University of Florida professor
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Arch Mainous said, "ultimately there’s a business aspect to it, whether the physician is thinking about it or not, whether the nurses think about it or not. But somebody is."
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KFF Health News and The Trace requested to speak with administrators at nine of Florida’s large hospital systems.
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None of the nine Florida hospital systems agreed to an interview with KFF Health News and The Trace.
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Sarah Cannon is the communications director at Tallahassee Memorial HealthCare.
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Sarah Cannon did not agree to an interview or address Alea Bates’ account of her care.
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