This study presents information on the 2014 prevalence and cost of emergency department visits and inpatient hospital stays for injuries associated with armed assault in 6 states: Arizona, Florida, Kentucky, New Jersey, North Carolina, and Wisconsin. We examine differences in utilization and patient insurance status between 2010 and 2014. From 2010 to 2014, the rate of hospital use remained stable in Florida, New Jersey, and North Carolina; increased in Kentucky and Wisconsin; and declined in Arizona. Costs per patient were high across states in 2014, ranging from $9,000 to $18,000. The burden of costs shifted from uninsured patients to public coverage in three states that expanded coverage for childless adults. Of this group, Kentucky and New Jersey expanded Medicaid through the ACA, and Wisconsin expanded coverage with state-only funding.