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Most bills disappear eventually.
You pay off your mortgage. Your car loan ends. Even 35% of borrowers with student loans get out of debt (while 25% default and the rest are in active repayment plans).
Mark Cuban argues that health insurance premiums are different.
"The one debt you can't and won't ever pay off," Cuban said of premiums at the American Medical Association's National Advocacy Conference earlier this year.
He later expanded on the idea on X, arguing that consumers have been wrongly conditioned not to think of premiums as debt even though they represent a lifelong obligation.
More recently, Cuban floated an alternative concept: What if consumers deposited that money into a medical account they controlled instead of sending it to an insurance company every month?
Cuban's notion is an interesting thought experiment about one of the biggest expenses American families face.
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How Cuban's proposal would work
Cuban used a family of five paying approximately $2,100 per month for an Affordable Care Act silver plan as an example.
Under his concept, the family would continue contributing roughly the same amount each month. But instead of applying the entire payment toward insurance, the money would be split into several buckets.
According to Cuban's outline:
- About $300 per month would go toward stop-loss protection, which would kick in once medical costs reach $30,000.
- About $200 per month would fund direct primary care services.
- The remaining roughly $1,600 would stay in a dedicated medical account owned by the family and could be used for approved health care expenses.
That money could be used for approved medical expenses. If it wasn't spent, it would remain in the account, earning interest. Cuban's proposal suggests account holders could keep the accumulated balance when they reach age 65.
"This is not insurance." Cuban wrote on X. "It's a specially designed bank account that gives you control, support, a doctor to work with and catastrophic financial protection."
Cuban's proposal has a familiar ring to it
The idea resembles a health savings account (HSA) in some ways because both involve setting aside money for medical expenses in investment-type accounts.
The key difference is that HSAs are designed to work alongside a qualifying high-deductible health insurance plan. The account helps cover out-of-pocket costs, but the insurance policy remains the primary source of protection against major medical bills.
Cuban's proposal flips that model. Instead of using a savings account to supplement insurance, the account itself would be the primary funding vehicle. His concept also includes catastrophic coverage and a lending feature that don't exist in a traditional HSA.
Why many may like it
The appeal is obvious.
Many Americans spend thousands of dollars annually on insurance premiums and never directly see a return on those payments. The money is gone regardless of whether they got sick or not. For these consumers — especially young, healthy ones who are financially struggling – it can feel like a waste of money.
Under Cuban's proposal, a portion of those monthly payments would remain the consumer's asset.
A healthy family that experiences few medical expenses could potentially accumulate a substantial balance over time rather than continually paying premiums without any ownership stake.
The proposal also aligns with Cuban's long-running criticism of the health care pricing structure. Since founding Cost Plus Drugs in 2022, an online pharmacy that cuts out the middleman, Cuban has argued that consumers benefit from transparent pricing and fewer intermediaries that play a smaller role.
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The biggest question: What happens if you get sick immediately?
The most obvious challenge is also the most important one.
What happens if a family signs up for this arrangement and then faces a major medical event before building a meaningful account balance?
For example, imagine a family contributes for only six months before a child develops a serious illness or a parent experiences a medical emergency requiring extensive treatment.
The account might contain only a sliver of the money needed to cover all bills.
Cuban anticipated that criticism and addressed it on X.
His proposal includes access to an optional loan of up to $30,000 to cover medical expenses before enough money has accumulated in the account.
According to Cuban, the stop-loss component would not directly pay individual bills. Instead, consumers could borrow against future contributions if necessary.
"You have the option, not the requirement of using the loan."
Cuban's answer addresses part of the problem, but it also creates a new one.
Who takes the lending risk?
If someone gets seriously sick before they've built up a meaningful balance, Cuban's answer is a loan of up to $30,000. But who is willing to make that loan?
The amount, $30,000, sits in an awkward middle ground. For many illnesses or injuries, it can barely make a dent.
At the same time, $30,000 is a literal fortune for most families. Few households can absorb that kind of debt. And for lenders, making unsecured $30,000 loans to millions of people experiencing a medical crisis carries obvious risk.
Traditional insurance spreads those risks across millions of policyholders. Cuban's proposal doesn't explain who would absorb them instead. Banks? A government program guarantor? Would the stop-loss provider take on the risk?
The financial and regulatory infrastructure needed to make Cuban's idea work could be substantial, if not fantastical.
Bottom line
Cuban's proposal isn't something consumers can buy today, and it isn't a legislative plan moving through Congress.
It's a public challenge to how Americans think about health insurance.
His core argument is that premiums are a debt. And unlike a mortgage or car loan, the payments never stop.
Whether consumers agree with that framing is another question altogether. Still, the idea highlights a frustration many Americans share: paying large sums for health insurance while feeling little ownership over the money they contribute.
The proposal is intriguing, but given the questions about lending risk, regulation, and catastrophic claims, don't count on nixing your current insurance plan any time soon. Quite the opposite, it's a smart idea to revisit rates and coverage so you can keep more cash in your wallet.
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