Such organizations, often formed to sidestep legislative requirements of the Affordable Care Act, regularly self-deal to maximize margins and have used their dominant positions to steer other healthcare companies from stepping outside of their networks or formularies, he said.
One potential fix that he said has his whole-hearted support is the longshot Break up Big Medicine Act. Introduced this February by Sens. Elizabeth Warren, D-Mass., and Josh Hawley, R-Mo., the bill would heavily penalize vertically integrated healthcare companies—for instance, a parent company that owns an insurer as well as medical provider, or a prescription drug wholesaler that also has a management services organization.
As it stands, the legislation is dead in the water with almost no backing from the senators’ respective parties. Cuban suggested that more lawmakers are currently on board with the bill than have publicly declared their support, and that their silence is another example of the large healthcare companies’ oppressive influence on the broader healthcare market.
“Don’t be a wimp. Seriously,” Cuban said during an on-stage interview. “I’ve heard there’s like five or six Democrats waiting to come out and support [the] senators, but they’re waiting to have five or six Republicans to step up with Josh Hawley.
“If you guys know anybody, my email is [[email protected]]. I’ll talk to [senators’] staff, I’ll talk to their whoever,” he continued. “I’ll talk to the senator, because until you break those companies up and make them divest their non-insurance assets, they own your healthcare … and there is no chance we will improve the quality and cost of care in this country.”
Cuban had a similar call-to-action for the executive branch, later telling President Donald Trump, the Federal Trade Commission and the Department to “do your job” and ensure that healthcare markets “are efficient and not dominated by special interests, or dominated by companies that create scale or regulatory capture, which is what we’re seeing in healthcare.”
Cuban was largely supportive of the administration’s healthcare affordability efforts, whether that be the launch of TrumpRx or the introduction of advanced programming interfaces (APIs) and other approaches to facilitate price transparency drug purchasing.
On the other hand, he said the administration was “pushing Medicare Advantage too much, [which] is run by those big insurance companies that I want to break up” and that Republicans’ alternative to extending now-expired insurance premium subsidies—direct deposits into HSAs—was just a different means of funneling money to insurers that didn’t address core pricing issues.
In a particularly provocative exchange, he demonstrated his broader point about conglomerates holding the reins by telling attendees that the types of brand-name drug manufacturers Trump has been cutting deals with are more afraid of a snub from a major PBM or insurer than they are of the president himself.
“They don’t really care what the president says or does, … they’re terrified of the big PBMs,” Cuban said. “A tariff is expensive, right? Pushing you from tier one on a formulary to tier five, [or] requiring coinsurance, is death. It’ll wipe out your company.
“It’s not even close. On a scale of one to 10, PBMs/insurance company [are a 10],” he said, emphasizing the point with a gesture. “President Trump, maybe a two.” Cuban added that he hopes the president sees the clip of his comments.
Cost Plus, which was launched in 2022 to bypass middlemen and lower drug costs, now carries 2,500 medications that are sold at acquisition cost plus a 15% fee to cover the business’ expenses and return a modest profit. Cuban said that he would like to do business with brand-name manufacturers as well to sell their products on the platform, but that similar threats from PBMs are limiting drugmakers’ options.
“You know why we don’t have all branded and specialty medications? Because those same PBMs that are owned by those big insurance companies—that I think should be broken up—they go to the CEOs of those brand manufacturers and they say ‘If you work with Cost Plus Drugs, we will diminish your placement on those formularies,’” he said referencing conversations with “several” unnamed manufacturer CEOs.
Cuban, during the on-stage interview, resisted prompts to align his affordability views with any particular political party, and outright refused to discuss his prior support of Vice President Kamala Harris in the previous election—“don’t remember, don’t care. Those days are gone … there’s no reason to relitigate.”
However, he said he would put his full support behind a Republican whose platform does “what’s best for the country” on healthcare affordability, and that an independent presidential campaign that focused all of its messaging on addressing healthcare costs would “would do really well” in 2028.
“But, it won’t be me,” he added.
