Amid Debate Over Health Insurance Coverage, Brady Report Highlights Dangers of Congressional Health Care Proposal to Gun Violence Survivors and Taxpayers
The mass shooting targeting lawmakers in broad daylight on a baseball field in Alexandria shocked Americans. As the country reeled from news of House Majority Leader Steve Scalise's uncertain prognosis after a gunshot wound to the hip, Congress continued its debate on repealing critical components of the Affordable Care Act (ACA) that literally mean the difference between life and death for victims of shootings. An estimated 22 million people will lose their insurance under the Republican healthcare plan being debated. Coverage guarantees under the ACA but missing from the new proposal would leave many severely-wounded gunshot victims without the critical treatment necessary for a full recovery—recovery that in many cases costs in the range of hundreds of thousands if not millions of dollars per patient
The cost of initial hospitalizations alone for victims of gunshots is more than $700 million annually. Average initial hospitalization cost per patient is approximately $24,000-32,000. For patients with complications, such as Rep. Scalise, the costs of treatment and recovery are many times that.
Initial hospitalizations and follow up care are covered under the ACA through individual insurance coverage, which cannot discriminate based on preexisting conditions, nor increase in cost as a result of such conditions. They are also covered by the Medicaid and Medicare programs, which cover more than 40 percent of the costs associated with initial hospitalizations for gunshot wounds. (Medicaid covered $2.3 billion of the $6.6 billion in costs related to initial hospital stays for gunshot victims from 2006-2014, according to a 2017 study). But an estimated 15 million people will lose Medicaid coverage under the Republican plan.
The epidemic of gun violence should be treated as a public health threat and an issue of concern to all taxpayers, particularly in the context of the healthcare legislation now being debated. If Congress enacts this plan, the cost of much of this care will shift to taxpayers and consumers with private insurance. Emergency treatment centers will be forced to offset unpaid debts from uninsured patients previously covered by Medicare, Medicaid, or private insurance with higher sticker prices for paying patients, and through greater contributions from other taxpayer-funded programs at the local and state level, which will result in higher private insurance rates and higher taxes.
Where does this leave gunshot victims? The Brady Center's report offers a window into the struggles of victims to access and afford care before the ACA's protections were in place. The report profiles a couple that amassed $5 million in medical bills after they were shot in a drive by shooting; a young man wounded by celebratory gunfire when he was 11 whose care has cost well over $15 million; a young boy who was shot in the head at 7 and whose mother lost her job because of her need to care for him; and a teen who uses a wheelchair after he was shot in the back while walking to the grocery store. The cost implications of their stories are not unique.
For most Americans with complicated injuries due to gun violence, the journey to recovery is long and dependent on costly but life-saving care. The healthcare legislation being considered by Congress today would reduce access and increase prices for that critical care, and potentially cost gun violence victims their lives. And this report does not even begin to calculate the cost of related mental health services for victims, survivors, witnesses, or first responders related to the trauma and post-traumatic stress from such shooting incidents