According to @mcuban, channeling taxpayer-funded $1,000 per month into HSAs reframes the actuarial value of recipients and, for those earning below the federal standard deduction, non-qualified spending would only incur a 20% penalty, leaving roughly an additional $10,000 per year to use, source: @mcuban. According to @mcuban, directing $1,000 per month into HSAs would also encourage more Medicare Advantage-type structures, with carriers setting up zero-premium plans, adding incentives, and matching deductibles to the HSA inflow, source: @mcuban. According to @mcuban, he guarantees these designs would produce a lower payout value than the worst ACA plan, implying leaner claim costs relative to ACA benchmarks from the insurer perspective, source: @mcuban. According to @mcuban, recipients could earn interest on HSA balances until used, but plans would steer spending to in-network providers at inflated prices, which he characterizes as a razors-and-razor-blades marketing model, source: @mcuban.

According to Mark Cuban, U.S. taxpayers rarely pay doctors directly, with funding flowing to states via Medicaid, to hospitals and providers via traditional Medicare, to insurance carriers via Medicare Advantage and ACA plans, and indirectly through tax benefits for individuals and employers (source: Mark Cuban on X, Nov 29, 2025). He says the system overpays because carriers are incentivized to scale, contract at inflated prices, invent fees, and delay or deny care, with PBMs contributing to the problem (source: Mark Cuban on X, Nov 29, 2025). He proposes breaking up big carriers by vertical and requiring intercompany transfers at Medicare rates or best price until structural changes are made (source: Mark Cuban on X, Nov 29, 2025). He calls to remove formularies from PBMs and to count extra cash drug purchases toward patient deductibles (source: Mark Cuban on X, Nov 29, 2025). He urges nonprofit hospitals and providers to publish every general ledger entry and to stop 340B abuse (source: Mark Cuban on X, Nov 29, 2025). He adds that caregivers benefit the least financially and argues doctors should be able to operate independent practices and receive the same Medicare rates as hospitals for the same work (source: Mark Cuban on X, Nov 29, 2025). He challenges employers to disclose their insurance and PBM choices and to walk away from the biggest carriers and their PBMs (source: Mark Cuban on X, Nov 29, 2025).

According to @mcuban, U.S. health insurance carriers are so large and vertically integrated that they set the rules, and he argues the ACA is not employer-driven (Source: Mark Cuban on X, Nov 28, 2025, twitter.com/mcuban/status/1994504415152120002). He states the solution is to break up the behemoth carriers to give the market a chance to become efficient, emphasizing antitrust-driven structural reform (Source: Mark Cuban on X, Nov 28, 2025, twitter.com/mcuban/status/1994504415152120002). He delivered these remarks in a reply to Bill Gurley’s post, underscoring criticism of vertical integration and rule-setting power within managed care (Source: Mark Cuban on X, Nov 28, 2025, twitter.com/mcuban/status/1994504415152120002; x.com/bgurley/status/1994451234732875864).