From 2016 to 2021, firearm injuries cost the U.S. healthcare system an estimated $7.7 billion in treatment expenses. Although urban trauma centers bear the greatest share of these costs, Medicaid reimbursement often falls short, leaving hospitals that serve vulnerable, lower-income populations to absorb significant losses. In this report, the Institute for Healthcare Policy and Innovation warns that recent Medicaid cuts adopted by Congress could further strain these already burdened hospitals.