This grant provides supplemental support for the study team at Urban Institute to use its Health Insurance Policy Simulation Model to analyze the coverage and spending implications of health care proposals that aim to move the U.S. health system toward universal coverage. Proposals modeled will be prototypes of those under discussion that range from incremental improvements to the Affordable Care Act, to the addition of a public plan, to single-payer and multipayer models. Estimates will include the distribution of health insurance coverage under current law and after the reform is implemented, as well as the distribution of health spending, by households, federal and state governments, and employers.