Mark Cuban has spent years picking fights with the companies that control how Americans pay for prescription drugs. He’s built an entire business around the idea that middlemen, not doctors or manufacturers, are the reason medicine costs so much.
Now he is bringing that fight into one of the most closely watched Senate races in the country.
The billionaire entrepreneur is teaming up with Texas Democratic Senate candidate James Talarico on a plan to break up what they call “Big Medicine monopolies,” giving Cuban’s long-running healthcare crusade a direct line into electoral politics just months before voters head to the polls in one of the tightest statewide contests of the cycle.
Mark Cuban and Talarico healthcare reform plan
Talarico, a member of the Texas House of Representatives running against state Attorney General Ken Paxton, unveiled the proposal in a plan first shared with CNBC. The two will appear together for a live event and podcast recording in Fort Worth on Aug. 29 to discuss the plan.
“Mark and I agree it’s time to break up the Big Medicine monopolies that control our broken healthcare system,” Talarico said, according to CNBC.
“Healthcare corporations are ripping us off, jacking up premiums and profiting off our pain. This plan will break up monopolies, lower medical debt, bring down the cost of prescription drugs, and ensure doctors decide what medication their patients need, not insurance companies.”
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Talarico cited data showing that 90% of all U.S. hospital beds are controlled by large hospital systems, and that three pharmacy benefit managers, CVS Caremark, Express Scripts, and Optum Rx, process 80% of all prescriptions nationwide, according to Fox26.
A central piece of the proposal is stronger antitrust enforcement aimed at vertically integrated healthcare companies — the insurers, pharmacy benefit managers, and hospital systems that increasingly own multiple links in the same supply chain.
Cuban’s statement backing the plan struck a deliberately bipartisan note. “I’ve spent a long time working to reduce the cost of healthcare for everybody,” Cuban said, as CNBC reported.
“Politicians in Washington have not. Whether you’re a Republican, Democrat, or an independent, you want more affordable, better quality healthcare. The plan James has put together will accomplish exactly that, which is why I am supporting it.”
Cuban’s Cost Plus Drugs track record
Cuban did not arrive at this endorsement casually. He co-founded the Mark Cuban Cost Plus Drug Company in 2022 to sell generic medications at the manufacturer’s cost plus a flat 15% markup, with pharmacy and shipping fees, while bypassing traditional middlemen such as pharmacy benefit managers, according to TheStreet.
That company has become the backbone of Cuban’s broader argument that the healthcare system is rigged by middlemen rather than doctors or patients. Cost Plus Drugs built its model specifically to sidestep the pricing structure used by traditional pharmacy benefit managers and has grown to challenge established rivals such as Walgreens, CVS, and Amazon, CNBC reported.
He has also backed the Break Up Big Medicine Act, introduced in Congress in February 2026, which would force large insurers to separate their PBM divisions, provider networks, and drug distribution arms from their core insurance business, according to CNBC.
His endorsement of Talarico builds on public comments he made weeks earlier. In an Aug. 21 appearance on the “Pivot” podcast with Kara Swisher and Scott Galloway, Cuban called Talarico “honest” and said he would “do the right thing instead of the politically expedient thing,” a preview of the alliance now playing out in the Senate race, according to CNBC.
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Why CVS UnitedHealth and big healthcare are watching
The proposal lands directly on the business model that has made CVS Health one of the most vertically integrated companies in American healthcare. Its structure combines Aetna insurance, CVS Caremark pharmacy benefit management, and thousands of retail pharmacies, according to GuruFocus.
CVS is not the only company exposed. UnitedHealth, Cigna, and Elevance Health could all face greater scrutiny if lawmakers moved to separate insurance, PBM, and provider businesses that have become increasingly intertwined over the past decade, GuruFocus noted.
Talarico and Cuban are not alone in pushing this argument. Sen. Elizabeth Warren has separately called for breaking up the same vertical integration at UnitedHealth, CVS, and Cigna, pointing to entities like Optum that link insurance, pharmacy, and provider services under one roof, according to CNBC.
What Cuban’s endorsement means for the Texas race
Cuban’s involvement gives Talarico’s campaign a business voice on an issue that consistently ranks among voters’ top concerns.
Healthcare affordability has become a defining theme of the race against Paxton. Polling shows the contest remains extremely tight, with Talarico holding a slim lead over Paxton in some surveys while trailing by a point in others, The Hill confirmed.
That tight margin makes an endorsement from a business figure like Cuban, who has spent years positioning himself as a critic of healthcare costs rather than a partisan actor, a potentially useful tool for a campaign trying to appeal across party lines in a traditionally Republican state.
Whether the plan itself ever becomes law is a separate question from whether it helps Talarico politically in a state Democrats have not won statewide in more than three decades, Fox26 reported.
For now, the proposal remains just that, a proposal. Still, the event scheduled for Aug. 29 in Fort Worth will be the clearest test yet of how much weight Cuban’s healthcare credibility can add to a campaign trying to flip one of the most closely contested Senate seats in the country.
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