Orlando Health and Florida Hospital will not bill survivors of the Pulse nightclub massacre for out-of-pocket medical expenses, officials announced Wednesday. 
 
 Instead, the hospitals will write off an estimated $5.5 million or more in care. 
 
 "The pulse shooting was a horrendous tragedy for the victims, their families and our entire community," Orlando Health President and CEO David Strong said. "During this very trying time, many organizations, individuals and charities have reached out to Orlando Health to show their support. This is simply our way of paying that kindness forward." 
 
 Its main hospital — Orlando Regional Medical Center — treated 44 of the more than 50 victims who needed immediate medical attention from the June 12 attack that killed 49 people. The nightclub is only a couple of blocks from the Level 1 trauma center. 
 
 Nine of the Pulse patients died shortly after arriving at ORMC, and their families also will not be charged, hospital officials said. One victim remains hospitalized there. 
 
 At Orlando Health, bills will be sent to health insurers for patients who had coverage, but whatever those policies don't cover will be absorbed by the hospital chain, said spokeswoman Kena Lewis. 
 
 At Florida Hospital, which treated a dozen of the clubgoers, officials said they would not even bill the victims' insurance for the treatment, nor will they bill for follow-up surgeries the survivors may need. 
 
 "It was incredible to see how our community came together in the wake of the senseless Pulse shooting," said Daryl Tol, Florida Hospital's president and CEO. "We hope this gesture can add to the heart and goodwill that defines Orlando." 
 
 Survivors welcomed the news. 
 
 "I was so worried because I can't afford any of that," said Mario Lopez, 34, who was visiting from Miami when he went to the club after a friend's housewarming party. 
 
 (Naseem S. Miller) 
 
 "I just went out for a fun night with friends. No one expected this to happen. My life was turned upside down, and then I had to worry about how I was going to pay back the hospital." 
 
 Lopez, who is uninsured, was grazed by a bullet and had fragments explode into his left side. After he was hit, he fell and split his elbow on a shard of glass. His seven-hour hospital visit left him with a new nightmare: a potential $20,000-bill. 
 
 "It's a huge relief" to know he won't have to pay, he said. 
 
 At Orlando Health, Lewis said the hospital would work with victims who will need future surgeries as a result of the shootings. 
 
 "We can't predict the future needs of these patients, their financial situations or what the state or federal governments may require us to do for charity policies," she said. "While we can't assume the answer is free care forever, we will use our very generous charity and financial assistance policies to assess the best way" to help. 
 
 As it is, the hospital chain is expecting to shoulder at least $5 million in unreimbursed care for the Pulse victims, many of whom had extensive injuries, Lewis said. Florida Hospital officials said the bills there totaled more than $525,000. 
 
 As for Lopez, his physical wounds are healing, he said, but the emotional trauma still feels raw at times. 
 
 "It's tough," he said. "Each day, I have my moments." 
 
 ksantich@orlandosentinel.com, @katesantich, 407-420-5503 chayes@orlandosentinel.com, @Journo_Christal, 407-420-5493 ||||| The Costs Of The Pulse Nightclub Shooting 
 
 Enlarge this image toggle caption John Raoux/AP John Raoux/AP 
 
 Mario Perez lives in Miami, but he was in Orlando for a housewarming party Saturday, June 11. After the party, the 34-year-old went to the Pulse nightclub for Latin night. 
 
 At 2 a.m., he heard gunshots. Loud. He knew it was real. 
 
 "And the minute he started shooting, I got hit from the side, I got grazed by a bullet," Perez says. "My first instinct was to fall to the floor, that's what you're taught to do." 
 
 He heard gunshot after gunshot after gunshot — too many to count. But then there was a brief break in the firing, and Perez ran out the back of the club. He hid inside the kitchen of a nearby 7-Eleven until police and paramedics showed up. He was taken to Orlando Regional Medical Center, and was at the emergency room from 3 a.m. until 8 a.m. 
 
 The gunshot wound on his side is purple and swollen, and he has nerve damage from the bullet fragment. He cut his elbow from glass on the floor of the nightclub and needed six stitches. Perez doesn't know how much bills coming from specialists, X-rays and tests might cost him. But his bill from Orlando Regional Medical Center's emergency department is $20,000. 
 
 "$20,000," Perez said. "That's the quote, that's what they told me." 
 
 Perez has no health insurance. He's working for a temp agency right now and doesn't have the money to be seen by a doctor for follow-up care in Miami. 
 
 So just how much will the Pulse nightclub shooting cost all of the victims? It's a difficult, if not impossible question to answer right now. At last check, 56 people had been brought to the hospital, including three patients who spent two weeks in the intensive care unit, and one patient who is still in the hospital in critical condition. 
 
 Embry Howell, a senior fellow at the Urban Institute, a think tank in Washington, D.C., studied the average cost of a gunshot victim in 2010. Using that benchmark, she estimates the hospital costs from the Pulse shooting will be about $1 million. 
 
 "And I would imagine that would be an underestimate," Howell said. 
 
 Howell said many of the victims may be in the same boat as Mario Perez: uninsured. 
 
 "They're young, primarily Latino and living in Florida," she says, a state that has not expanded Medicaid to its population. 
 
 "My guess would be you have a high rate of uninsured," she concludes. 
 
 Ted Miller, a researcher with the Pacific Institute for Research and Evaluation, has been studying the cost of firearm injuries for more than two decades. He used the 2011 shooting of former U.S. Rep. Gabby Giffords and 18 others in Arizona to make what he calls a conservative estimate: $4 to $7 million in medical costs and mental health costs for victims and survivors of people who died. 
 
 That's lifetime medical costs for the survivors, the costs of surgery and rehab — but it doesn't count long-term costs for those who are severely injured. 
 
 "They said some time ago that there were six people in ICU who would have longtime, serious consequences," Miller said. "And my guess is most of those folks will have traumatic brain injuries that will have continuing lifetime care." 
 
 Miller also makes a broader estimate beyond just the medical costs. That includes the cost of the police response, the cost to employers — and the dollar value of those 49 lost lives. 
 
 "I estimate that the total cost of the Orlando shooting is around $385 to $390 million," Miller says. "To put that in context, on that same day, the cost of other gunshot wounds in the U.S. was probably about $600 million. So about 1 1/2 times the cost of the Orlando incident. That tells you that there are a lot of people killed and injured by firearms every day in this country," he says. And, he explains, "Suicide deaths account for the largest share of gun violence costs." 
 
 Miller's $385 million estimate doesn't include the cost of mental health counseling for people who were in the club but not physically shot — and friends and family of those there. And then there's the cost of fear: people being afraid to go out to a dance club, or maybe skipping a visit to the theme parks. 
 
 Orlando Regional received 44 of the shooting victims. A hospital spokeswoman says some patients have insurance coverage, some don't. The hospital is going to look for payment sources from the community or the state, such as victim funds that are raising money across the country. But she says the hospital expects unreimbursed costs of more than $5 million. 
 
 Pulse shooting victim Mario Perez is calculating his personal costs. He's worried he's going to lose his job. He's anxious knowing millions of dollars have been raised to help victims, but his bills are arriving now. He started his own GoFundMe campaign, but it's only raised about $600. 
 
 "As long as it gets covered, I'm going to be fine," Perez said. "If they don't cover it, I'm stuck in a hole. I don't know what I'm going to be able to do if they don't assist me." 
 
 This story is part of a reporting partnership with NPR, Health News Florida and Kaiser Health News.
– They were fortunate enough to survive a gunman’s rampage that killed 49 others at an Orlando nightclub. But in the weeks following the June 12 massacre at Pulse, many survivors who needed medical treatment found themselves living another nightmare. Besides haunting memories, they suffered debilitating injuries that required painful surgeries and ongoing care. Some were uninsured. Now, Orlando hospitals are offering relief. Orlando Health and Florida Hospital announced Wednesday they will forgive an estimated $5.5 million in unpaid medical bills, the Orlando Sentinel reports. "We hope this gesture can add to the heart and goodwill that defines Orlando," says Florida Hospital CEO Daryl Tol. NPR reported last month that when long-term care is factored in, medical bills of Pulse survivors could reach $390 million. Blocks away from the nightclub, Orlando Regional Medical Center treated 44 shooting victims. One survivor remains hospitalized there. The hospital, run by Orlando Health, will bill insurance companies but cover any remaining costs, a spokeswoman said. The families of nine people who died there will not be sent a bill. Florida Hospital said it won’t bill the insurance companies of the dozen club-goers treated there, and all future care will be covered as well. Survivors welcomed the news. "I was so worried because I can't afford any of that," Mario Lopez tells the Sentinel. Lopez, 34, was hit with bullet fragments on the left side and has no insurance to cover a $20,000 ER bill. "It’s a huge relief."