Hey guys, remember Darcie Johnston? Former head of Vermonters for Health Care Freedom, the conservative advocacy group that fought tooth and nail against single-payer health care? Wannabe campaign consultant with a dismal track record? Former Trump administration functionary who had a lead role in one of its many fuckups during the early days of the Covid pandemic?

Well, it has come to my attention that Johnston is now Deputy Director of something called the Alliance of Health Care Sharing Ministries, which lobbies in D.C. and state capitols on behalf of an industry that profits off the gullibility of conservative Christians — a business model that’s never been known to fail.

Health care sharing ministries market themselves to Evangelical types as a cheaper option for health coverage — but when it comes to regulatory oversight, insist they are not insurers at all, just simple humble charities. The last thing they need is pesky state or federal regulators sticking their noses into the Lord’s work.

In an HCSM, members pay a set fee per month, which goes into a big pot of money that then pays health care bills incurred by other members. It works, as long as there’s enough bucks to pay the bills. Otherwise, members often find themselves shit out of luck even if they’ve been loyally paying into the system.

“We try our best to advise consumers that [HCSMs are] not insurance,” Gerard O’Sullivan of the Connecticut Department of Insurance told Connecticut Public Radio. “There is no protection under state law for people who sign up for these programs.”

Because HCSMs are unregulated, the department doesn’t even know how many state residents are enrolled in the programs. (The Alliance claims nationwide enrollment of 865,000 in member HCSMs.) Department officials believe HCSMs have enjoyed a boost since the onset of the Covid pandemic, when many people lost their insurance coverage and were seeking low-cost options.

Connecticut regulators have warned consumers of the risks of signing on with an HCSM, and issued cease and desist orders against two “ministries” for deceptive marketing.

HCSMs are also exempt from most of the rules in the federal Affordable Care Act. They don’t have to cover pre-existing conditions, aren’t required to cover what the ACA defines as essential services, and they can impose annual and lifetime caps on payouts to members.

These ministries were small potatoes until the ACA became law. Membership then exploded because HCSMs could cut costs by skirting the law’s requirements, and because many conservative Christians wanted nothing to do with Obamacare.

As with every other aspect of life in conservative and Christian circles, the industry has attracted more than its share of scammy operators. ProPublica did an exposé of “one of the nation’s largest sharing ministries” operated by “a family with a long and well-documented history of fraud.”

Four years after its launch in 2014, the ministry enrolled members in almost every state and collected $300 million in annual revenue. Liberty used the money to pay at least $140 million to businesses owned and operated by Beers family members and friends over a seven-year period, the investigation found. The family then funneled the money through a network of shell companies to buy a private airline in Ohio, more than $20 million in real estate holdings and scores of other businesses, including a winery in Oregon that they turned into a marijuana farm.

The family patriarch, ProPublica reported, “plays in high-stakes poker tournaments around the country, travels to the Caribbean and leads big-game hunts at a vast hunting property in Canada” and generally lives a lifestyle described by a former ministry exec as having all the all the “trappings of large money coming his way.”

Enrollees, meanwhile, often found medical bills gone unpaid or their coverage canceled with no warning or explanation.

Another ministry was investigated by the FBI for taking in “$7.5 million in membership payments, of which only $250,000 (3.2%) went on medical expenses.”

I could go on, because there are plenty of examples. Many states have gone after HCSMs for fraud. I’m sure there are honest operators as well, but the lack of regulatory oversight makes the industry an open invitation to fraudsters — and fundamentalist types tend to be easy marks.

Johnston is now making her bones trying to keep HCSMs as unburdened by state and federal regulations as possible. Nice work if you can stifle the screams of your conscience.