Expanding federal healthcare programs in the US would have broad implications for the US economy and the credit quality of the US sovereign. » Public insurance proposals would lower costs for many but raise fiscal risks for the US sovereign, albeit to varying degrees. Improving affordability and access to care for more US households would be positive for consumption and consumerfacing sectors. Lower healthcare costs could also increase corporate margins and free resources for state and local governments. The fiscal impact on the US sovereign would depend on how these programs are financed and on the effectiveness of cost saving measures. » Limited public option proposals would have only a modest positive impact on consumers. This proposal type would introduce a low-cost public option on the marketplaces established under the Affordable Care Act (ACA) and enhance federal subsidies for those purchasing coverage on that market. A limited public option would lower healthcare costs for a relatively small share of the population and would not significantly affect healthcare spending for employers and state and local governments. The impact on federal healthcare outlays would be minimal and potentially positive. » Expansive public option proposals could have larger effects on consumers, employers and the US sovereign. Healthcare costs could fall for a much larger share of the population under this proposal type, as well as for employers, because people with employer-sponsored health insurance would be allowed to switch to the public option and be eligible for federal subsidies. The fiscal impact would depend on the public option's ability to contain costs and offset higher subsidies in the ACA marketplaces. » Single-payer would have material macroeconomic and credit effects. A single-payer system, often referred to as “Medicare-for-all,” that eliminates direct healthcare costs for households, employers and state and local governments would have large stimulative effects. However, these effects would be tempered by the impact of new revenue measures needed to fund the system. Federal spending would rise significantly, but the net fiscal impact would depend on how the new system is financed and its effectiveness at reducing costs