Mark Cuban Proposes Texas Healthcare Reform Plan
Business owners may soon see new options to bypass PBMs without affecting employee deductible credits.
Updated on Oct. 21, 2026 in Healthcare
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Mark Cuban proposed a five-step healthcare reform plan to Texas House lawmakers on September 1, 2026, aimed at increasing transparency and market competition. The proposal specifically targets pharmacy benefit manager (PBM) practices to help businesses and individuals address the fact that 51% of U.S. adults cannot afford quality healthcare.
Why it matters
Cuban argues that a lack of price transparency in the current system creates barriers to care for employees and employers alike. By seeking to reform PBM contracts and insurance credit policies, the plan aims to reduce the overhead costs that currently limit medication accessibility.
Three PBMs manage 80% of U.S. drug claims, a dominance Cuban characterizes as a barrier to price competition. Meanwhile, 51% of U.S. adults report being unable to afford quality healthcare.
The players
Mark Cuban
An entrepreneur and advocate for pharmacy price transparency through his company, Cost Plus Drugs.
CVS Caremark
One of the three major pharmacy benefit managers that collectively manage 80% of U.S. drug claims.
Express Scripts
A dominant pharmacy benefit manager serving as a central entity in the national drug distribution chain.
OptumRx
A major pharmacy benefit manager controlling a significant portion of the U.S. medication claim processing market.
Josh Hawley
A U.S. Senator who co-sponsored federal legislation aimed at restructuring the pharmaceutical medicine market.
The details
Cuban’s plan seeks to decouple insurance coverage from PBM mandates, proposing that patients should use cheaper pharmacy options without sacrificing credit toward their deductibles. He also drafted a model contract for government entities to standardize PBM negotiations. This approach attempts to move away from current industry contracts that Cuban describes as contractual terrorism by forcing higher transparency in drug pricing.
Timeline
March 2026: Sens. Josh Hawley and Elizabeth Warren introduced the Break Up Big Medicine Act.
May 2026: TrumpRx added over 600 generic medications via Cost Plus Drugs.
September 1, 2026: Mark Cuban testified before Texas House lawmakers.
Market Landscape
Cuban’s testimony builds on the momentum of the Break Up Big Medicine Act, currently pending in the Senate Judiciary Committee. His state-level proposal mirrors the federal push to reduce the concentrated power of PBMs.
Business owners should review their current pharmacy benefit contracts for transparency clauses that might mimic the model contract proposed by Cuban. Watch for potential state-level legislation that could allow employees to use lower-cost pharmacies without losing deductible progress.
The takeaway
Operators should track whether Texas adopts these PBM contracting models, as they may become the standard for private employer health plans. Review your current PBM provider’s transparency reporting to ensure you are not locked into unfavorable terms that obscure the true cost of employee medications.
Further reading
For more on industry shifts, see Healthcare.
Live Poll
Should the government implement stricter regulations on pharmaceutical middlemen to lower consumer healthcare costs?
