As shoppers hunt for holiday bargains this season, they may find something unusual for sale at the mall: Obamacare.
With enrollment deadlines looming, California officials, insurance companies and agents are staking out retail space to sign up thousands of people as part of the Affordable Care Act. These sales tactics reflect how dramatically the healthcare law is changing the insurance industry.
Until recently, most health insurance companies and agents didn't put much time into selling policies to individuals and focused more on catering to employers and large groups in the workplace. But the health insurance mandate and billions of dollars in federal premium subsidies have made individual policies a far more attractive market.
California's health insurance exchange and other government-run marketplaces are rushing to sign up people by Dec. 23, the deadline to have coverage in effect Jan. 1. Open enrollment lasts until March 31.
A state lawmaker and union organizers last week opened a mall store in a predominantly African American area of Los Angeles. In Orange County, insurance agents are signing up dozens of people each week at Laguna Hills Mall, and healthcare giant Kaiser Permanente has rented five retail locations in Northern California to sell exchange policies.
The Covered California exchange has posted solid enrollment since opening Oct. 1, primarily through its website and call centers. It has signed up nearly 80,000 people in private health plans through Nov. 19 and an additional 135,000 people have applied for Medi-Cal, the state's Medicaid program for the poor.
But the exchange estimates that about 80% of people will want in-person help to figure out their insurance options. Rather than set up storefronts itself, Covered California has focused more on training people who then go out to farmers markets and health fairs to promote the exchange and do enrollment.
Some consumer advocates welcome the increased retail exposure, but they worry that stores run by insurers or agents might push certain health plans and leave out other choices on the exchange.
"Having a lot of venues where people are running errands is a good thing," said Betsy Imholz, special projects director at Consumers Union. "But we want to avoid inappropriate steering. There are upsides and downsides to this."
State Sen. Holly Mitchell (D-Los Angeles) said she pushed for a Covered California store at the Baldwin Hills Crenshaw mall because many lower-income people who stand to benefit most from the healthcare law aren't likely to click on a website.
"There are still people who don't have access online," Mitchell said. "We want to bring health insurance to where people are naturally, and the clock is ticking on the enrollment window."
Billboards for Covered California surround the Baldwin Hills mall, beckoning people to "health insurance made affordable." The small store is on the mall's second floor, across from a nail salon and a short stroll from Macy's and Foot Locker.
It has a counter stacked full of insurance brochures and a small table where state certified enrollment counselors use a laptop to answer people's questions and help them get coverage.
Capri Capital Partners, the mall's Chicago owner, said it donated the space until open enrollment ends March 31. The location is open seven days a week with afternoon and evening hours.
Brenda Hardson, 51, was handed a brochure about the mall store recently and came back with her uninsured daughter, Rickesha Morris. The 31-year-old was recently laid off from her job and she sat down with an enrollment worker to review her options.
"It's always better to speak with someone face to face," Hardson said. "The website only answers general questions."
In Northern California, Kaiser has hired 40 people to run its five stores in San Jose, Sacramento, Modesto and Fresno. A sixth location is planned for Stockton in December.
The Oakland nonprofit said it got 10,000 visitors to two mall kiosks it opened last year, and it drew lessons from that experience.
"We know people have a lot of questions about healthcare reform, how to get coverage and what kind of financial assistance might be available to them," said Wade Overgaard, a senior vice president at Kaiser Permanente.
Kaiser says its store workers are certified by the state and will enroll people in Kaiser policies as well as competitors' health plans.
Inside Laguna Hills Mall, the Insurance Resource Center is signing up more than 100 people per week as part of the healthcare law rollout. Gary Mann, a senior partner with Nationwide Senior Plans, said he and a partner opened the 3,000-square-foot store in mid-October.
Eight agents, all trained and authorized to enroll people by the state exchange, cover the store seven days a week. It features signs for Covered California and major insurers, such as Anthem Blue Cross.
The agents don't charge people to answer their questions or enroll them in a health plan or Medi-Cal. Rather, the agents get paid commissions by the insurance companies.
Mann said the store is seeing an increase in traffic from policyholders who are having their existing coverage canceled Dec. 31 because it doesn't meet all the requirements of the Affordable Care Act.
Covered California rejected President Obama's recent call to extend those canceled plans for another year, and an estimated 1 million Californians are losing their current policies.
That has angered many consumers, and Mann said others who oppose the healthcare law vent at his store.
"We get some hostile people and they shout at us," he said.
His biggest concern, however, is people putting off their insurance shopping until the last minute. "People procrastinate," Mann said, "and if everyone jumps on at the end, it will really test the system."