Dr. Anthony Douglas, a medical resident on track to become a trauma and acute care surgeon, knows the toll of gun violence. In his work at the University of Chicago Medicine Trauma Center on the city’s South Side, he’s seen the frantic operating rooms, funerals, and hospital bills that often end up in the public ledger. Gunshot wound victims arrive without insurance cards, but care comes anyway. The invoices float upward — to victims’ families, to hospitals, to Medicaid, to taxpayers.

“We are subsidizing the cost of firearms,” he told me. “If they actually carried the accountability, guns wouldn’t be as cheap as they are.”

Douglas is the architect of a policy experiment designed to change that math. If it proves successful, it could set the stage for a national shift in how the gun industry pays for the harms its weapons cause.

Backed by a growing coalition of Illinois state lawmakers and advocates, Douglas is pushing a bill called the Responsibility in Firearm Legislation Act, or RIFL Act. If passed, it would require manufacturers that want access to Illinois’ market to obtain a state license and pay into what amounts to a compensation fund for gun violence. Think of it as workers’ comp — but for gun injuries and deaths — shifting some of the burden from victims and taxpayers back onto the industry that profits from the product.

The concept borrows from other privately funded safety nets. For a century, workers’ compensation has replaced uncertain lawsuits — which left both injured workers and employers in limbo — with a reliable fund, financed by employers. The money covers medical care and lost wages, and the system puts pressure on companies to make job sites safer. “We’re trying to mimic that exact same concept,” Douglas said. 

Under the plan, a gun company’s annual contribution would scale with how often its firearms are recovered in fatal incidents, shootings, and suicides in Illinois. The more frequently a company’s guns are found to create public costs, the more it would pay. Hospitals could bill the new fund directly for health care costs after a firearm injury. Families could get help with lost wages, emergency relocation, child care, and transportation.

The compensation fund would also serve as a way to hold the gun industry financially accountable without litigation. Taking manufacturers to court rarely proves successful thanks to the gun industry’s broad legal immunity. For two decades, the federal Protection of Lawful Commerce in Arms Act, or PLCAA, has insulated gunmakers from most lawsuits over third‑party misuse of their products, meaning that the gun industry is rarely held financially responsible or forced to cover any costs, unlike other industries. The RIFL Act sidesteps that terrain by using a licensing fee to cover compensation instead of damages in court.

Supporters and the bill’s legislative sponsor say lawyers have reviewed the framework and believe it could withstand constitutional scrutiny, although they readily concede the industry would almost certainly sue. “Anything now can be argued in terms of constitutionality,” Douglas said, “but this is designed to avoid PLCAA.”

The political argument is both moral and pecuniary, said Dr. Selwyn Rogers Jr., a trauma surgeon for 35 years and founding director of the University of Chicago Medicine Trauma Center. He said he has watched medicine drive down deaths from car crashes through a mix of engineering and policy mandates including seatbelts, airbags, collapsible columns, and better-designed roads.

He argued that a similar incentive shift is missing in firearms. “If there are penalties, people will make different choices,” Rogers told me. He points to technologies — biometrics or microstamping — that could make guns less likely to be used by anyone other than their owner. “We use technology to make our lives more efficient,” he said. “What about if we used the same technology and applied it to guns?”

Those technological features have so far languished without any buy-in from the nation’s largest gun manufacturers, even in states that have ostensibly required such enhancements.

“These are things that they say are impossible or cost-prohibitive, but we know will help make a dangerous weapon at least a little less dangerous,” said State Representative Kevin Olickal, the legislation’s House sponsor. “These are things they refuse to do because there’s no compelling reason to do so. This could be one of those ways that we can compel manufacturers to be more responsible.”

But the path ahead is not simple. The coalition says it has stacked up a large share of the votes needed in the Illinois House and Senate — where Democrats hold significant majorities — if it can secure full buy‑in from Democratic Governor JB Pritzker and win over a couple of quiet skeptics in leadership. Pritzker’s office did not respond to a request for comment. Sponsors said they expect lawmakers to take up the bill when the Illinois General Assembly returns for the second year of its biennial session in the spring.

“We’re optimistic about the coalition that we’re building, and we’re hopeful that we can get something done in the next year,” Olickal told me.

If Illinois succeeds, the ripple effects could be national. The RIFL framework has already drawn interest from legislators in Michigan and New Hampshire, and supporters believe it could begin to spread the way workers’ compensation laws did a century ago — or like safe storage and red flag laws have in the past decade for gun violence. 

Because gunmakers ship products across the country, even a small cluster of early‑adopting states could set a de facto national standard. Manufacturers would have to build the cost of restitution funds into their business model everywhere to retain access to those markets. Advocates see that as the long game. State‑level innovation could fill a federal vacuum, create real economic incentives for prevention, and normalize the idea that firearms — like cars, oil drilling, chemical manufacturing, or opioids — carry industry responsibility for the public harm they cause.

The framework’s design also targets one of the persistent weaknesses of state‑by‑state gun policy: the interstate pipeline. Because RIFL pegs fees to firearm recoveries in Illinois, not the point of sale, it would capture guns trafficked in from Indiana or Mississippi, which are source states for guns that frequently show up in Illinois. For advocates like Sara Knizhnik, co‑founder of the gun violence prevention organization Safe Illinois, that’s the “true brilliance” of the bill. “If the gun is sold in Indiana, crosses state lines, and is recovered in Illinois, it doesn’t matter where it originated,” she said. “What matters is what company the gun originated from.”

Gun rights advocates are loudly opposing the measure. The National Rifle Association has called the RIFL Act a “dangerous proposal that could effectively shut down firearm manufacturing in Illinois.” And Alan Gottlieb, the founder of the Second Amendment Foundation, which regularly sues to counter gun laws, said the bill is “nothing more than a massive revenue generator to feed the state coffers at the expense of everyone in the firearms industry, starting with gunmakers and ending with gun dealers, who will pass these costs on to consumers.”

Douglas and his allies have prepared for that fight with spreadsheets. Their early modeling — using preliminary recovery data and spreading company responsibility across the units they sell — suggests per‑gun price increases measured in tens of dollars for large manufacturers, with a “worst‑case” retail price bump of around 13 percent. According to Douglas’s preliminary estimates, Smith & Wesson, for example, would face a license fee of roughly $20 million per year. 

“But when you put that into how much it would increase the cost per firearm for a Smith & Wesson, it would only increase each firearm they sell by about $20,” Douglas said. “The increase in the cost of a firearm is honestly modest compared to what every single taxpayer pays for firearm injury.”

The remaining several hundred million dollars the legislation could raise from license fees would be spread across dozens of manufacturers and importers whose guns show up at crime scenes and suicides.

“Will it be a little bit more cost-prohibitive? Maybe,” Olickal said. “But it’s not going to be to the point where somebody who is already purchasing a firearm is not going to be able to. These companies rake in tons of money, and they can find a way to pay these costs.”

Knizhnik called current gun prices “artificially low” because taxpayers pick up so much of the downstream tab. If gunmakers use the opportunity to be more responsible with how they’re selling guns, she said, costs should go down. 

“Once this bill is passed and a system is in place to incentivize safer products and practices,” she said, “each year the cost to the manufacturer should go down, which means that they will be free to pass on those cost savings to their consumers by lowering the price. The solution is built into this policy.”

While the idea is certainly unprecedented for guns, versions of it already exist across other high‑risk industries. 

Nuclear operators are required to contribute to a shared insurance pool under the federal Price‑Anderson Act to cover damages from accidents beyond their own insurance. Oil companies pay a per‑barrel tax into the federal Oil Spill Liability Trust Fund so cleanup and restitution costs don’t fall to taxpayers. Insurance carriers are required by state law to pay into guarantee associations that backstop consumers if a company fails. Vaccine manufacturers pay a tax that goes into a similar risk fund in exchange for some legal immunity. Chemical producers once funded the EPA’s Superfund program through industry taxes that financed toxic‑site cleanups, and many extractive industries — from strip‑mining to landfills — pay into state assurance funds to cover reclamation or closure costs. 

The RIFL Act’s supporters argue that the firearms industry should no longer be an exception.

Senator Robert Peters, a Democrat who is carrying the bill in the state Senate, said his South Side district includes the University of Chicago Medicine Trauma Center and neighborhoods that have endured disinvestment and high rates of violence. “My responsibility is to the working people of Illinois, who shouldn’t be footing the bill,” he said. “If you don’t want to be stuck with a financial burden as a manufacturer, then make sure what you’re manufacturing isn’t going to be showing up at a murder scene.” 

When, in the 1970s and 1980s, carmakers warned that seatbelts and airbags were ineffective and that a requirement to install them could bankrupt the industry, lawmakers went ahead and approved mandatory safety features, anyway. “All we’re asking is: Create a seatbelt for your product,” Peters said.

The fund created by the licensing fees could shift millions in costs off public programs, supporters argue, particularly Medicaid, which is facing steep federal cuts after Republicans passed the “Big, Beautiful Bill Act” earlier this year. That budget act slashed funding for the federal low-income health insurance program. RIFL could also stabilize a community violence prevention ecosystem that has often lived hand‑to‑mouth, and is also facing federal funding cuts and widespread grant cancellations under President Donald Trump’s administration. 

Because of those cuts, former U.S. Education Secretary Arne Duncan, who now leads a Chicago anti‑violence organization, said there’s a need for reliable funding. As the city logs its safest summer in decades and arrests fall, federal funding cuts could stunt that progress. “Public safety is a public good,” he told me. “We’re trying to build this permanent public safety and public health infrastructure. Having consistent, recurring revenue allows you to scale and build the kind of infrastructure you need not just to sustain the progress you’ve made, but to continue to get better, faster.”

While the existing version of the legislation largely focuses on medical bills and other direct costs, RIFL’s backers say they plan to write dedicated support for community violence intervention into the bill as federal aid wanes. 

Knizhnik said she has spent a decade advancing what she calls “Band‑Aid” policies and sees this as a rare chance to go at the problem’s roots. “We’ve passed enough Band-Aid bills when it comes to gun violence prevention in the United States, certainly in Illinois,” she said. “We need to start getting serious about passing policies that get at the root causes of the problem.”

If fees nudge the industry to design safer products and police its own supply chain, the bill’s supporters say, the public may finally see the kind of safety curve that transformed America’s roads. 

“We accept this as normal,” Rogers said of the daily toll of gunfire. “We should not accept this as normal.”