James Talarico’s Healthcare Plan, Backed by Mark Cuban, Targets Monopolies, Prescription Prices, Insurance Denials and Patient Costs
Democratic U.S. Senate nominee James Talarico has unveiled a healthcare plan aimed at breaking up what he calls “Big Medicine,” earning the support of businessman and entrepreneur Mark Cuban.
The proposal targets large healthcare conglomerates, pharmacy benefit managers, insurance companies and hospital systems that Talarico says have used industry consolidation to raise prices and limit patients’ choices.
“James Talarico’s plan will break up healthcare monopolies and lower the price of medicine,” Cuban said. “I’ve spent a long time working to reduce the cost of healthcare for everybody — politicians in Washington have not.”
Cuban, who co-founded the Mark Cuban Cost Plus Drug Company to offer lower-priced medications, said affordable healthcare crosses political lines.
“Whether you’re a Republican, Democrat, or an independent — you want more affordable, better quality healthcare,” Cuban said. “The plan James has put together will accomplish exactly that, which is why I am supporting it.”
Breaking Up Healthcare Monopolies
Talarico’s proposal calls for supporting bipartisan antitrust legislation, including the proposed Break Up Big Medicine Act, to address vertically integrated healthcare corporations.
Those corporations can include insurance companies that also own pharmacy benefit managers, pharmacies, physician practices and other parts of the healthcare system.
Mark and I agree it’s time to break up the Big Medicine monopolies that control our broken healthcare system. Healthcare corporations are ripping us off — jacking up premiums and profiting off our pain.
James Talarico
Talarico said his proposal would break up monopolies, reduce medical debt, lower prescription drug prices and ensure that doctors — rather than insurance companies — determine which medications and treatments patients need.
Lowering Prescription Drug Costs
The plan would require greater transparency from pharmacy benefit managers, commonly known as PBMs. These companies negotiate drug prices and benefits for insurance plans but have faced federal scrutiny over their market concentration, pricing practices and relationships with affiliated pharmacies.
Talarico proposes preventing PBMs from concealing pricing information, increasing negotiating power for lower prices, encouraging the development and approval of generic medications and placing limits on patients’ out-of-pocket expenses.
The plan also seeks stronger regulation to prevent PBMs from increasing prices through undisclosed fees or receiving hidden financial incentives.
The three largest PBMs — CVS Caremark, Express Scripts and Optum Rx — processed nearly 80% of prescriptions dispensed in the United States in 2023, according to the Federal Trade Commission.
An FTC investigation also found that the three companies generated more than $7.3 billion in revenue from marked-up specialty generic drugs between 2017 and 2022. The companies have disputed allegations that their business practices increase healthcare costs.
Giving Patients More Control
Under Talarico’s proposal, patients would be allowed to shop for medications outside their insurance networks when they find a lower price. Those purchases would then count toward their insurance deductibles.
The plan would also reform prior authorization, the process through which insurers determine whether they will cover a medication, procedure or treatment recommended by a healthcare provider.
Talarico wants to prevent insurers from arbitrarily denying medically necessary care and give doctors greater authority over treatment decisions.
Another provision would classify PBMs and third-party benefit administrators as fiduciaries when managing pharmacy benefits. That designation would legally require them to prioritize patients’ interests instead of decisions intended primarily to maximize corporate profits.
Healthcare Costs Continue to Rise
The proposal comes as American families face rising insurance and medical expenses.
The average annual premium for employer-sponsored family health coverage reached $26,993 in 2025, representing a 6% increase from the previous year, according to KFF’s Employer Health Benefits Survey. That amount includes contributions from both employers and workers.
Talarico’s campaign also cited the continued consolidation of hospitals and physician practices, arguing that reduced competition allows large health systems to charge higher prices.
The campaign says approximately 90% of U.S. hospital beds are now controlled by large hospital systems. It also cited research indicating that hospital mergers can lead to price increases of between 40% and 50% in highly concentrated markets.
Texas Leads Nation in Uninsured Residents
Healthcare affordability is particularly significant in Texas, which continues to have the country’s highest uninsured rate.
Approximately 16.7% of Texans — about 5.1 million people — lacked health insurance in 2024, compared with a national rate of approximately 8%, according to an analysis of U.S. Census Bureau data. America’s Health Rankings also places Texas last nationally for health insurance coverage.
Talarico’s campaign said many uninsured Texans earn too much to qualify for Medicaid but work in jobs that either do not provide health insurance or offer plans that remain unaffordable.
“Healthcare corporations are ripping us off — jacking up premiums and profiting off our pain,” Talarico said. “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.”
Talarico and Cuban are scheduled to discuss the proposal Saturday in Fort Worth during a live podcast recording moderated by political commentator Jessica Tarlov.
Talarico is the Democratic nominee challenging Republican Texas Attorney General Ken Paxton in the 2026 U.S. Senate election.
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