Mark Cuban on the $38 Trillion National Debt and U.S. Healthcare Costs

Mark Cuban has called for major changes in the U.S. healthcare system, arguing that the $38 trillion national debt is exacerbated by inefficiencies in health care spending. On Christmas Eve, Cuban proposed a plan to penalize insurers and providers for over-billing or incorrect denials, suggesting that such measures could help reduce the national debt. He emphasized the need for transparency and efficiency in the healthcare market.

Cuban's critique highlights the role of middlemen in the healthcare system, such as pharmacy benefit managers, who he says drive up costs by exploiting information asymmetry. His company, Cost Plus Drugs, operates as a direct-to-consumer model that cuts out these intermediaries. He argues that similar models could help reduce overall healthcare spending and national debt.

The expiration of enhanced Affordable Care Act (ACA) subsidies at the start of 2026 has shifted more of the healthcare cost burden onto consumers. This change has led to rising premiums and deductibles, affecting millions of Americans who rely on ACA coverage. Insurers like UnitedHealth Group and CVS Health have seen stock gains as a result of these changes.

Why the Move Happened

The lapse of ACA subsidies has increased the financial burden on individuals, prompting a debate over the affordability of health care. The expanded subsidies introduced during the pandemic were designed to reduce monthly premiums for higher-income enrollees and eliminate premiums for some lower-income individuals. With those credits lapsed, average out-of-pocket premiums for ACA users are expected to more than double.

Mark Cuban's criticism of insurers highlights the growing concern over high deductibles, which can delay or prevent patients from receiving necessary care. He argues that these higher deductibles keep patients paying full drug prices for longer periods, increasing their out-of-pocket costs. He also criticizes rebates generated by deductible spending that often flow to large pharmacy benefit managers owned by insurers.

How the Market Responded

The stock market has shown a mixed but generally positive reaction to the change in ACA subsidies. UnitedHealth Group, CVS Health, and Molina Healthcare have all seen their shares rise in the early part of 2026. UnitedHealth touched a three-month high, while CVS reached nearly two-month highs and Molina hit its strongest level in over two months according to market data.

Retail sentiment on Stocktwits was described as 'extremely bullish' for UnitedHealth and 'bullish' for Molina Healthcare. The message volume for UnitedHealth was 'high,' while it was 'normal' for both CVS and Molina.

What Analysts Are Watching Next

The debate over ACA subsidies has stalled in Congress, with Democrats generally supporting an extension and Republicans divided. Some Republicans have raised concerns about the potential cost of extending the subsidies, which could exceed $300 billion over 10 years.

Paragon Health Institute has launched the State Health Reform Initiative, aiming to reduce fraud, lower health care costs, and protect the vulnerable by implementing evidence-based, free-market policies at the state level. The initiative focuses on strengthening Medicaid program integrity, refocusing Medicaid on the most vulnerable, and removing barriers to care.

Connecticut's chief fiscal officer has warned against pulling back Medicaid spending, arguing that maintaining or increasing investments in the Medicaid program is crucial to ensuring regular access to care. The state has faced challenges in balancing Medicaid spending with other fiscal priorities, including pension debt.