In this brief we update previous estimates of the impact of alternative public option proposals. We consider proposals that apply to the nongroup health insurance market only and some that would apply both in the nongroup and employer health insurance markets. We also consider alternative provider payment rates. We showed the impact on premiums in both non group and employer markets, the number of people uninsured and spending by employers, households and the federal government. Effects are much greater if the if the public option is extended to employer markets rather than limited to the nongroup market. Impacts also vary considerably with how much provider payment rates are reduced.