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The U.S. proposed new Obamacare rules Friday that it says will make it easier for people to shop for health insurance, protect them from some out-of-pocket costs, and help states run the marketplaces where plans are sold.

The changes would apply to insurance plans sold on the Affordable Care Act’s marketplaces for 2017, the law’s fourth year of coverage. Consumers will buy those policies starting on Nov. 1, 2016. The rules are still in proposal form and will have to be finalized after a period of public comment.

The proposal “seeks to improve the consumer experience, both when individuals shop for health insurance and when they use it,” the Centers for Medicare and Medicaid Services, which oversees many aspects of the law, said Friday in a statement.

One proposal would cut down on what the government called “surprise bills” when a patient goes to an in-network hospital and gets care from a provider who isn’t in their insurance plan. That can result in paying higher, out-of-network rates that don’t count toward the maximum amount patients are supposed to have to spend out of pocket. The proposal would count some of those services toward the patient’s out-of-pocket maximums.

“The question for exchanges over time is how they would evolve,” said Elizabeth Carpenter, a vice president at Avalere Health. “What we’re seeing in this rule is a move toward additional consumerization and transparency.”

U.S. Website

Another change would let states use the federal government’s health insurance sign-up system, which includes the website healthcare.gov. The law gave states the choice of building their own health insurance shopping marketplaces, or having the federal government do so. A minority of states initially opted to build their own markets and some, like Hawaii, have since shifted to use the U.S.’s market infrastructure instead.

Another proposal would create a set of standardized plan options on the federal marketplace, to make it easier for consumers to compare offerings from different insurers. It would be up to individual insurers to decide whether to issue plans with that design, and HHS said it might display the plans on its healthcare.gov website “in a manner that makes it easier for consumers to find and consider them.”

The proposed rules come a day after UnitedHealth Group Inc. said it might quit selling individual plans on the Obamacare marketplaces, because they hadn’t been profitable. Health insurers have been going through a period of turmoil as they sell coverage on the market, with Aetna Inc. and Anthem Inc. also saying the markets either haven’t been profitable or aren’t yet as profitable as they’d like. In addition, about a dozen nonprofit “co-op” plans created under the Affordable Care Act have failed, after charging too little to cover the cost of patients’ medical care.

Choosing Plans

The proposal would allow the federal exchange to take a more active role in deciding which health plans can sell coverage, similar to what California’s state-run exchange has done, Carpenter said. Yet with UnitedHealth weighing whether to stay in the market, the federal exchange may not have much room to tighten its rules, she said.

“We see United and the co-ops making comments about the sustainability of the exchange market, so it will be interesting to see how payers react,” Carpenter said.

The proposed rules on networks would also push states to set their own network-adequacy criteria, or substitute a federal rule based on how long it takes patients to get to a health-care provider or how far away that provider is. The U.S. also asked for feedback on how to better inform individuals about the size of their plan’s network when they’re shopping for coverage.