Mark Cuban Asks What If You Didn’t Need Health Insurance — And Hospitals Just Treated You, Then Took 10% of Your Pay?

Health insurance may be one of the few products people pay for every month while hoping they never have to use it. Billionaire entrepreneur Mark Cuban thinks there might be a better way.

On July 3, Cuban took to X, formerly Twitter, with a proposal that would flip the traditional health insurance model on its head. Instead of Americans paying premiums to insurance companies, he suggested nonprofit hospitals provide care first, then finance whatever patients can’t afford through a zero-interest repayment plan capped at 10% of their income.

“What if instead of you buying insurance, Non Profit hospitals were required to provide care,” Cuban wrote. “It would be at a zero interest rate, with the monthly repayment, deducted from your paycheck, set at 10pct or less of your income.”

Under the proposal, Medicare and Medicaid would remain unchanged, while taxpayers would guarantee hospitals payment at 100% of Medicare reimbursement rates.

A Different Way to Pay for Healthcare

Cuban argued that taxpayers already back a wide range of financial obligations, from mortgages to student loans, making healthcare a logical next step.

“Taxpayers guarantee small business loans. Guarantee student loans. Guarantee mortgages. And more,” he wrote. “Why not the cost of care that is beyond your means?”

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He believes eliminating insurance companies from much of the payment process would reduce administrative costs and allow hospitals to spend less time battling claims and more time treating patients.

“This means the hospital won’t lose money,” Cuban wrote. “They won’t deal with insurance carriers and the incremental overhead burden.”

After users questioned whether a 10% payroll deduction would be too much for lower-income workers, Cuban clarified that the repayment would be “up to” 10% and would be means-tested for people earning above the Medicaid threshold.

Not Everyone Was Ready to Sign Up

The thread drew a wide range of responses from Cuban's followers and healthcare watchers. Supporters appreciated the simplicity and potential to cut bureaucracy, with some calling it a refreshing alternative to the current premium-heavy model. 

One commenter noted it could eliminate the constant fight with insurers and give patients more predictable costs. Others liked the direct hospital focus, saying it might reduce the “middleman” waste that drives up expenses today.

Critics pushed back hard on practicality. Many worried that a 10% paycheck deduction would feel like garnishment for lower earners already stretched thin, potentially replacing insurance premiums with another long-term burden.

Fraud concerns were common—“Look at what’s already happening in Medicare and Medicaid,” one user replied. 

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Others questioned whether hospitals could survive primarily on Medicare rates and whether turning the government into the “servicing entity” for repayments would create even more administrative headaches.

The discussion highlighted just how difficult healthcare reform remains, even when the goal is making care more affordable and accessible.

One Post, One Big Question

Cuban has spent years challenging traditional healthcare models, most notably through Cost Plus Drugs and his ongoing critiques of insurers and PBMs. Whether this latest idea gains traction or stays a thought experiment is uncertain, but it adds fuel to one of America’s most persistent debates: how to deliver care without the current layers of cost and complexity.

At its core, Cuban is asking Americans to imagine a system that works in reverse—receive the care first, then figure out a manageable way to pay. In a country where medical debt remains a leading cause of financial stress, that kind of rethinking is exactly what keeps the conversation going.