KFF Health News23%
Florida Hospitals Act Fast To Discharge Gun Victims — Especially if They’re Not Insured 9%
By Daniel Chang0% Fred Clasen-Kelly0% Olga Pierce0% The Trace14%
6/29/2026, 9:00:00 AM
BS Summary: This article contains 32 faulty reasoning types, including Appeal to Authority, Overconfidence Bias, and Anecdotal, with Post Hoc (False Cause) as the most egregious example at 13.2% saturation with 275 hits. Analysis detected 2,036 faulty-reasoning hits from 2,088 analyzed words, generating a BS Score of 25.4% and a BS Rank of 9% (20,053 of 21,886 articles). This article is better (less manipulative) than 91.60% of the article peer group.
Alea Bates wasn’t ready to leave Tallahassee Memorial HealthCare’s main hospital four days after a stranger shot her seven times at close range.
Miraculously, hospital records show, none of the bullets damaged her internal organs.
But after surgery, Bates said, she couldn’t get out of bed or walk to the bathroom without help.
She complained of intense pain radiating down her left leg, weakness in her knee, and a numbing sensation below it, according to hospital records.
Bates, who worked as an Uber Eats driver, didn’t have the strength to drive a car.
Still, Bates said, the hospital told her it was time to go.
“They didn’t do any further X-rays or CTs or MRIs to figure out why my knee was numb,” she said.
“And they were just like, you'll go away.’”
Doctors said she was medically stable, Bates said, and because she had no health insurance, they could not send her to a rehabilitation hospital or a skilled nursing facility, which can charge thousands of dollars a day for such care.
“They were just like, *We need the bed for somebody who has insurance*,” she said.
“That's of course, you know, what they say without saying it.”
At least one firearm injury is treated in an American emergency room every 30 minutes.
Tens of thousands die from their injuries every year.
Many more, like Bates, are left to face long recoveries, steep medical debt, and enduring trauma.
How insurance affects the care of gunshot wound victims has remained shrouded in mystery — until now, due to a new analysis by The Trace and KFF Health News of data that Florida hospitals compile to collect payments from insurance companies and file with the state.
When uninsured patients arrive at hospitals in Florida with gunshot wounds, on average they spend significantly fewer days in the hospital — in some cases half the time — than those with health insurance, according to the data analysis.
Among the most severely injured patients, the uninsured stayed three fewer days in the hospital on average than their counterparts with insurance.
The data was obtained exclusively for this reporting on gun violence hospitalizations in the state, aided by Florida state law.
The newsrooms spent more than a year analyzing the records, which did not identify patients.
The data contained patients’ insurance status, their residential ZIP code, their race, and other demographic info.
Reporters reviewed academic studies and government documents and interviewed health policy experts, doctors, activists, and victims of gun violence or their relatives.
The results are a first-of-its-kind look at what happens to the insured and the uninsured who are shot and admitted to the hospital for treatment.
Across Florida, the analysis of hospital billing data from 2018 to 2024 obtained from the Florida Agency for Health Care Administration shows:
* Uninsured patients make up a quarter of the more than 20,000 gunshot wound hospitalizations identified, making them the largest single group treated for firearm injuries.
* Uninsured gunshot victims had hospital stays of about six days on average, only three-quarters of the time spent by patients with private insurance and less than half the average stay for patients on traditional Medicaid, the public health insurance program for poor and disabled people.
* The gap in hospital care persisted regardless of hospital size, location, or ownership type, including at facilities that receive taxpayer money with a mandate to treat all patients regardless of their ability to pay.
* Of the gunshot wound patients, nearly half were Black, making the group highly overrepresented.
About a quarter of nonwhite patients were uninsured, versus fewer than a fifth of white patients.
The inequality echoes a long history of discrimination in U.S. healthcare against Black and Latino patients, groups that suffer disproportionately from firearm violence and a lack of health insurance.
The U.S. has more gun violence deaths than other wealthy nations, and no group suffers more than Black Americans like Bates.
Black people are far more likely to become victims of a firearm homicide than white people, according to the Johns Hopkins Bloomberg School of Public Health.
Police found Bates lying on the ground in the breezeway of an apartment building the night she was shot seven times after making a food delivery in December 2019.
Crime scene photos documented blood and casings from the assault.
Patient outreach workers say hospital personnel might perceive gunshot victims as gang members or troublemakers who deserve blame for getting shot.
One study found rehab centers refuse to admit gunshot victims more often than other patients, and some medical records from hospitals were littered with racist or insensitive descriptions of patients and their behavior.
Bates said she did not believe race was a factor in the care she received.
But she believed that the circumstances surrounding her shooting — that it happened while she was working, and that she did not know the shooter — affected the way doctors and nurses viewed her.
Language in medical records can sometimes signal a bias in clinicians and perpetuate differences in care that patients receive, said Jonathan Jay, an associate professor at the Boston University School of Public Health who conducts research on exposure to gun violence.
Jay said bias based on patients’ race, income, or insurance status can deny some people necessary treatment once they leave the hospital.
He said his research suggests the healthcare system treats gunshot survivors and motor vehicle accident victims differently based on perceptions of “whether the victim was in no way at fault.
They made assumptions when a person was violently shot.”
“The results are consistent with what we hear so much from hospital outreach workers for gunshot victims,” he said.
“They say there is substantial bias.
There is an assumption that they contributed to their condition with risky behavior.”
The preoperative notes in Bates’ medical records describe her as “a pleasant 39-year-old female who sustained multiple gunshot wounds to her abdomen, pelvis and extremities last night after performing Uber Eats delivery.”
Bates said it mattered to her caregivers what she was doing when she was shot.
“The nurses and doctors, they all talk about that stuff,” she said.
“They were like, ‘Oh, my God, you were ambushed.
That's so scary.’
“I was working.
Like, I don't know these people.
And the fact that they were teenagers, I think that that is what maybe changed the narrative,” she said.
“Because I feel a lot of times people blame you for what happened.
“But when I was asked and I told them what happened and my story and how I got there,” she said, “I think just the shock in people's eyes of like, ‘Oh, my God.
So you really were, like, you know, minding your business.’”
She added: “And it also wasn't in a sketchy part of town, if I can just say that.
I was in a predominantly white complex.
So I think that's what saved me.”
Bates had received care at the hospital before as an insured patient.
She had lost her job in the legal department of a state agency — along with her insurance — two months before she was shot.
As an uninsured patient, Bates said, “they kind of just dismiss you.
It makes you feel like less than a human being.”
She said she felt ignored when she told doctors she didn’t feel safe going home after four days.
She said the physical therapist working with her at the hospital had persuaded the facility to let her stay an extra day.
“We would like, as a medical community, I think as a society, to see everybody get the same care,” said Englum, the University of Maryland trauma surgeon.
“Regardless of what color their skin is, what insurance status they have — we want them to get appropriate care.”
The reason for racial or ethnic differences in care is hard to tease out, Englum said.
Is it that there’s mistrust of the medical system in some Black and Latino communities, leading people to avoid going to rehab because they don’t want to be there?
Is it an income issue?
Is it that medical providers see some patients and, due to implicit or explicit bias, think, “That’s as good as they’re going to get?”
“Getting that care is what you need to get your full functional outcome back.
And if you're not getting it,” he said, “patients are suffering that didn't have to.”
At home, Bates said, she depended on family members to help her out of bed, drive her places, even help her feel safe out in public.
“I really didn't know how to stand or move or walk around,” she said.
“I had to figure it out.”
She still fears loud noises, which remind her of being shot.
Bates said she and her dog stay indoors on July Fourth and New Year’s Eve.
“The fireworks were going off, and I was paralyzed,” Bates said of her first New Year’s Eve after being shot.
“I was literally sitting there crying.
My cousin actually came outside and put my noise-canceling headphones on and turned the music on so that I couldn't hear anymore.
That's the only way that I could move from outside to inside.”
Bates said her follow-up care included getting her stitches removed at an orthopedic clinic that has physicians who work at the hospital and had performed the initial surgery.
During the visit, Bates said, the orthopedic clinic’s staff reminded her of the unpaid balance from her surgery, which was about $1,200 for physician services.
She still owed the hospital $52,000 for treatment, according to her medical bills, and an additional $5,300 for the anesthesiologist.
Bates was not working at the time.
Bates said a community outpatient clinic provided physical therapy at a reduced cost and that the victim advocate unit at the Tallahassee Police Department helped find her mental health counseling and get her financial aid from Florida’s compensation fund for crime victims.
By 2021, Bates developed a cyst on the gunshot wound to her right thumb, which required surgery.
But, she said, the clinic would not perform the surgery until she paid her $1,200 balance.
She said friends paid the bill so she could have the surgery.
Bates’ knee bothered her.
“Even with going through physical therapy,” she said, “it was still like I couldn't feel it.”
Bates said she now has private health insurance that pays for her mental health therapy.
She pays for physical therapy out-of-pocket.
“It's crazy that in this country somebody else can hurt you,” Bates said, and “you have to pay for what they did to you.”
“So it's like you're triple-paying: You're paying every day mentally, you're paying with the bills, and you're paying by them saying, *We know that this is not your fault, but we still have to make our money*.”
KFF Health News data editor Holly K.
Hacker contributed to this report.
This article was produced in partnership with The Trace, a nonprofit newsroom covering gun violence in America.
Sign up for its newsletters here.
Methodology
The Trace and KFF Health News examined more than 20 million inpatient hospitalizations in Florida from 2018 to 2024, using data obtained from the Florida Agency for Health Care Administration.
We identified 20,255 gunshot wound-related visits using the Centers for Disease Control and Prevention’s injury surveillance case definition, which relies on ICD-10-CM diagnosis codes.
We limited the analysis to initial encounters and excluded patients who died in the hospital or left against medical advice.
We excluded cases in the top 1% for hospital length of stay (68 days or more) to prevent these outliers from disproportionately influencing results.
Our primary finding compares the average length of stay of uninsured patients with that of privately insured patients.
We chose privately insured patients as the reference group because many researchers believe their care on average is long enough to be effective but not longer than medically necessary.
Overall, uninsured patients had hospital stays that were about 25% shorter on average than privately insured patients’ and 50% shorter than those of patients on traditional Medicaid.
In most cases we also found that, within the same hospital, uninsured patients had shorter stays than privately insured ones.
To assess whether age or injury severity explained the shorter lengths of stay for uninsured patients, we calculated injury severity scores and fit regression models for Florida’s highest-volume gunshot wound hospitals.
We found that, in nearly all cases, the gap narrowed slightly but did not disappear.
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Analysis
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