Using the current House health care reform bill (H.R. 3962) as our analytic framework, we have updated our earlier age rating analysis, providing comparisons of the distributional implications of 3:1, 2:1, and 1:1 (no age variation, pure community rating) rating. We summarize the implications of the rating rule decision for insurance coverage, the costs (government and private) associated with reform, and the implications for household financial burdens. The analysis shows that, in the context of comprehensive health care reform, choice of premium rating rules applied to health insurance coverage has significant implications for the distribution of financial burdens.