Mark Cuban has a new target for his crusade against high healthcare costs: Medicare Advantage. On Friday, the billionaire investor and entrepreneur blasted what he called runaway costs in the program, arguing that private insurers are being overpaid by taxpayers compared to traditional Medicare. It's part of his broader, vocal campaign against opaque pricing and the middlemen he says drive up costs for everyone.

In a post on X, Cuban framed it as a direct hit to household budgets. He said families are effectively footing the bill for extra payments to large insurers because government spending on Medicare Advantage exceeds what it costs to cover people in traditional Medicare. He also argued that this math often ignores the added costs—like higher premiums—that people in traditional Medicare plans have to bear.

Here's the core of his argument: Medicare Advantage was originally designed to cost less than traditional Medicare. Cuban contends the program has drifted so far from that goal it's now doing the opposite. "EVERY SINGLE FAMILY IN THE USA IS PAYING $800 A YEAR," he wrote, because insurers receive more public funding than he believes is necessary. He called that outcome "irrational" and said it conflicts with the program's original promise.

So what's his solution? Cuban is urging support for the "Break Up Big Medicine" bill, which is backed by an unlikely duo: Republican Senator Josh Hawley (HAWLEY) of Missouri and Democratic Senator Elizabeth Warren (WARREN) of Massachusetts. He's also tying the entire spending debate directly to the ballot box, suggesting voters should withhold support from candidates who won't back this proposal. He's basically saying, if you're mad about healthcare costs, this is the bill to watch and these are the politicians to pressure.

This legislative push fits with Cuban's wider thesis. He doesn't think the U.S. healthcare problem is just about the sticker price of pills; he thinks it's baked into how the industry is structured. In a PBS interview earlier this month, he described insurers as being "so vertically integrated they literally control and set the pricing of all the economics." He argues that price opacity is a key reason consumers and employers are in the dark. "Even though its their largest expense after payroll, they have no idea how their benefits work," he said of employers.

A recurring villain in Cuban's narrative is the pharmacy benefit manager, or PBM. He singles them out as a major source of confusion in drug pricing, something he says other developed countries don't have to deal with. "The one thing from a business perspective that differentiates the United States versus all the other developed nations when it comes to drugs, we have these things called pharmacy benefit managers," he said in the PBS interview. "They don't. Period. End of story."

He describes PBMs as creating a system where even the people paying the bills can't easily track true costs. Waiting for the market to fix this problem isn't good enough, in his view. "The market can fix the problem, but its going to take a long time and people are going to die," he argued, making the case for policy changes that would force more competition now.

Outside of the policy fight, Cuban has tried to model his idea of a simpler, transparent system through his online pharmacy, Cost Plus Drugs. The venture is built on showing all the inputs and markups instead of negotiating behind closed doors. "We're transparent," he described. "We show you our actual cost, our literal actual cost. We show you our markup, which is only 15%, and if its mail order, its $5 to ship it to you. That's it." For him, publishing prices isn't just good ethics; it's a competitive weapon.

So, to sum up the Mark Cuban healthcare playbook: shout about the $800 he says every family is paying because of Medicare Advantage, point the finger at PBMs and vertical integration as the structural culprits, champion a specific Senate bill as the fix, tell voters to make it an election issue, and run a business on the side to show how transparency could work. It's a full-court press against the way medical bills get paid.