On February 18, a 22-year-old man arrived at the University of Maryland’s Cowley Shock Trauma Center in Baltimore with a dozen gunshot wounds to his chest. Dr. Thomas Scalea, in an effort to save his life, opened his sternum, closed two holes in his heart, and repaired a blood vessel in his chest.

The patient lived, but his treatment cost thousands. He still has weeks in the ICU, Scalea, the head of trauma at the hospital, told a Maryland legislative committee on February 22. The man was one of at least 600 gunshot wound victims the trauma center sees in a year, a number that has increased since 2019, Scalea said. Many are uninsured, placing a financial burden on families, the state, and its medical systems.

Scalea was testifying in support of a bill that would levy an 11 percent tax on the sales of firearms, ammunition, and gun accessories, with most of the revenue going to fund trauma services like those offered at the Cowley Shock Trauma Center. 

“It aligns the resources with the burden of the disease,” he told the committee.

Scalea’s testimony comes in the wake of recent legislation out of California. Last September the state became the first to levy an excise tax on firearms and ammunition, in the amount of 11 percent, when Governor Gavin Newsom signed the bill into law. Since then, lawmakers in more than a half-dozen other states have introduced similar bills to tax the gun industry to support hospitals, violence intervention and prevention programs, and services and compensation for victims of gun violence.

Colorado, Vermont, New York, Massachusetts, Washington, and New Mexico are among the states where lawmakers are considering similar bills, a Trace review found. Most are modeled after California’s 11 percent tax on firearm manufacturers and retailers. 

California was the first state to enact such an excise tax, but at least three municipalities have also done so: Seattle and Tacoma, Washington, and Cook County, Illinois. Pennsylvania also adds a $3 surcharge on firearm sales to support the state’s background check system. 

The federal government has, since 1919, imposed a national excise tax of 10 to 11 percent on the import and production of firearms to support wildlife conservation; the state taxes would be in addition to the federal tax.

In Maryland, the Legislature’s nonpartisan Department of Legislative Services estimated that the tax could generate $18.7 million in revenue in its first year, with the total growing to more than $24 million by the end of the decade. 

Senator Sarah Elfreth, the Senate sponsor and a Democrat, said, “We’re looking to make sure our world-class trauma system has the funds needed to continue to save lives and continue this conversation that gun violence is a public health crisis.”

Previously, a $5 fee on motor vehicle registration has funded the state’s trauma fund. For years, motor vehicle injuries were among the leading causes of hospital injury visits. But gun deaths have outpaced motor vehicle deaths in Maryland since at least 2010, and by 2020, in 34 states across the country.

California’s firearms tax largely goes to support community violence intervention and prevention. Other states, like Colorado and New Mexico, are planning to use the revenues for victim compensation and services. In Maryland, about a quarter of the funding would go to support an existing violence prevention program fund and a proposed Center for Firearm Violence Prevention within the state Department of Health, with the intent of providing stable funding for programs that are often deeply underresourced.

“Money is going to run out,” Maryland Delegate Bernice Mireku-North, a Democrat sponsoring the House version of the bill, said. “That’s why we’re just working on trying to get sustainable funding for these programs.”

Some excise taxes, like those on alcohol and cigarettes, are often referred to as “sin taxes,” with the intent of reducing consumption. But given that guns are durable goods more like motor vehicles, a tax may not lead to fewer guns on the street, unlike in the cases of cigarettes and alcohol, where taxes have been shown to reduce consumption. There’s little empirical evidence to indicate how taxation would influence firearm prices, the overall supply of weapons, or rates of gun violence, according to a RAND Corporation analysis of academic research. 

But lawmakers in Maryland said a sin tax was never their intent. Rather, it’s a response to a crisis.

“There’s a cost. What if that gun gets into the wrong hands? How do you deal with that?” Mireku-North said. “I view it more as dealing with a public health crisis rather than trying to tax sin.” 

Other states are also considering their own firearms tax bills: In Missouri and Ohio, Republican lawmakers have filed bills to exempt firearms and ammunition from sales taxes. Republicans in Maryland — and in the other states where firearm taxes have been proposed — are opposing the measures. Delegate Jason Buckel, a Republican, pushed back on the bill during the February 22 committee hearing.

“I’m not sure how imposing a tax on all lawful gun owners — people who are not ever shooting someone, who are not committing crimes — I don’t understand how putting a tax on them meets that objective,” he said.

Maryland’s legislative session is almost halfway done. Bills must be approved by their original chamber by March 18, or they might not become law. The session ends on April 8.