Mark Cuban's Next Move: Blowing Up Health Insurance With 'The 10 Plan'

Mark Cuban — fresh off exiting Shark Tank and selling the Dallas Mavericks — is setting his sights on health insurance, the most entrenched and repeatedly failed target of would-be disruptors. His concept, tentatively called 'The 10 Plan,' would replace traditional employer-sponsored insurance premiums with personal contributions capped at 10% of income, deposited into bank accounts usable only for medical expenses. The structure would fund primary care and a catastrophic backstop policy, with a built-in lending mechanism to cover mid-range costs users can't immediately afford — future monthly deposits would repay those loans over time.

The insurance idea grew directly out of Cuban's work with Cost Plus Drugs, his pharmacy startup that purchases mostly generic medications and resells them at a flat 15% markup with full price transparency. He describes the company as 'about breakeven' and has ruled out an IPO, saying bluntly that personal enrichment isn't the motivation. The company has already generated a flood of testimonials from patients who avoided catastrophic bills — one example cited was a drug with a $20,000 retail price that Cost Plus carried for $150.

A central villain in Cuban's telling is the pharmacy benefit manager (PBM) — the middlemen who manage drug formularies and claims processing for insurers. He argues that after major insurers absorbed PBMs (CVS buying Aetna being the clearest example), the combined entities gained near-total control over healthcare pricing through vast webs of intercompany transfers. The largest such entity, he says, moves $160 billion in intercompany transfers, effectively setting prices across the entire system to its own advantage.

The GLP-1 weight-loss drug revolution cracked open a major fault line. Employers balked at covering $1,300-per-month injectable costs — a price Cuban attributes directly to PBM markups — pushing Novo Nordisk and Eli Lilly toward direct-to-consumer pricing. Cuban gives partial credit to the TrumpRx program for negotiating those prices down, noting Cost Plus recently added its first drug to the platform (a Genentech flu medication called XOFLUZA) and has an API ready to instantly expand TrumpRx's catalog from 53 drugs to thousands.

Cuban also acknowledged a notable structural barrier to Cost Plus expanding into brand-name drugs: PBMs have reportedly warned major manufacturers like Pfizer, Bristol-Myers Squibb, and Lilly that selling through Cost Plus at net prices would result in their products being downgraded on insurance formularies — a credible enough threat that those companies have declined to work with him. He says he's reported the practice to both the FTC and the Department of Justice.