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Mark Cuban is in the news again after his X post claiming "Every single family in the USA is paying $800 a year to big insurance companies..." He's referring, in part, to the growing costs of Medicare Advantage, originally pitched as more efficient than traditional Medicare.
Cuban argues that it's a huge financial burden for the US government, one that's passed on to taxpayers. While it may seem like a policy issue, it's more relevant to retiring securely than you might think.
Here's what may be behind Cuban's sentiment and how it affects the average American trying to afford healthcare.
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What is Medicare Advantage?
Medicare Advantage is a set of private healthcare plans paid a fixed amount per enrollee to manage enrollees' Medicare claims. It's different from traditional Medicare in that these private insurers bundle Parts A and B and add extras (like dental or vision coverage). It also has a patient spending cap.
However, consumers must follow additional network rules set by individual private health insurers when using Medicare Advantage that don't apply to traditional Medicare. These include which doctors they can go to.
The cost of Medicare Advantage
Policy experts claim that Medicare Advantage costs 14% more than it would cost to insure the same people under traditional Medicare plans in 2026. The difference is around $76 billion, or a tax burden Cuban claims is about $800 per family.
A bipartisan Joint Economic Committee report found Medicare Advantage overpayments already pushed Medicare Part B premiums up by about $212 per enrollee in 2025. So, the trend isn't getting any better, and it has people like Cuban taking aim.
Cuban's blunt diagnosis
The Shark Tank alum shared his view on why U.S. healthcare costs so much. It's not just because of waste or fraud, Cuban argues, but due to the market structure rewarding a few big health conglomerates.
His argument goes something like this: Insurers do more today than pay out claims and have amassed their fortunes in almost every point in the patient journey. They own or control physician groups, management service organizations, pharmacy benefit managers (PBMs), and even some pharmacies.
So, when the same company sets the price for care as it does for the coverage for that care, it tends to reward profits over affordability. Cuban frames this as an antitrust and competition problem rather than just a budgetary concern.
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PBMs as "Darth Vader"
Cuban has also labeled PBMs as the "Darth Vader of the pharmaceutical industry." PBMs sit between drug manufacturers, pharmacies, insurers, and employers to manage how prescriptions are filled and what they cost at the pharmacy counter.
He perceives them as operating in the shadows, capturing large rebates, and not at all incentivized to share any savings with the customer. Again, the same people own insurers and the specialty pharmacies, so it can look like profit at every point in the patient care process (premiums, drug margins, and pharmacy pricing).
How the Break Up Big Medicine Act may help
His view isn't unique. Many politicians on both sides of the aisle have expressed concerns about PBMs' business practices, and Senators Elizabeth Warren and Josh Hawley have even teamed up to propose the Cuban-approved "Break Up Big Medicine Act".
Its core rule is this: A single parent company can no longer own both a health insurer and a PBM or physician provider group. They'd have to pick one side of the transaction.
The bill includes protections against similar price setting by wholesalers and other points in the supply chain and would be subject to oversight by the FTC and DOJ. It mirrors the Glass-Steagall Act for banks, only it specifically keeps health entities from owning both the care and management processes.
The Cost Plus Drugs test case
Cuban has talked a lot about the problem but has also gone to great lengths to solve at least part of it, too. His Cost Plus Drugs program offers transparent online pricing for generic pharmacy drugs at acquisition cost plus a fixed 15% markup. A small pharmacy fee and shipping also apply.
Consumers can see ingredient costs and fees to know exactly where their money goes, a completely transparent model that's counter to drug pricing today. This effort won't fix everything, but it's a small step toward demystifying healthcare costs and could serve as inspiration for similar companies.
Independent analyses find that some generic medications are much cheaper from Cost Plus than even some insured copays, evidence that we may have a big opportunity to shrink the cost of meds.
Bottom line
Medicare Advantage enrollment is at record levels, but premiums have risen another 10% this past year. So, the cost and design affect many seniors receiving healthcare today. Since healthcare is also a very much a wildcard, unpredictable budget expense, even the best retirement planning may not cover premium increases and swings in prescription drug coverage.
While people like Cuban and politicians fight to change the system, you'll need to take retirement cost savings measures into your own hands. Review your Medicare Advantage or traditional Medicare plan every year to compare out-of-pocket limits and drug formularies, and consider pivoting if you're not seeing the savings you were promised.
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