President Donald Trump shared on social media a text message he received this week from U.S. Senator Rand Paul (R-KY). The Kentucky Senator, a sometime Trump critic, was pitching his solution for America’s enduring health care challenges.
Paul’s idea is to allow Americans to collectively buy health insurance through Amazon and big box retailers like Costco and Sam’s Club. (Paul asserts that his plan to replace the ACA — or Obamacare — with plans from retail giants will “improve health care and lower costs.”)
— Anna Paulina Luna (@realannapaulina) December 3, 2025
Note: Paul first introduced his plan via the “Obamacare Replacement Act” during the first Trump administration, but as Paul wrote in his recent text to Trump, the Democratic Attorneys General “fought it in court.”
Paul suggested to Trump that they now have a better chance of pushing it through Congress with a Republican majority in both the Senate and House.
I continue to support the repeal of Obamacare and replacing it with true free market reforms, not just some rearranging of the current system.
My Health Marketplace and Savings Accounts For All Act is the only truly conservative option.https://t.co/ZZn5mEbuoP
— Senator Rand Paul (@SenRandPaul) December 2, 2025
Billionaire entrepreneur Mark Cuban, who owns Cost Plus Drugs, replied to Paul and his plan on X today. Cuban wrote: “If you plan on the existing big insurance carriers offering plans to retailers and associations, this plan will be garbage.”
[Note: Sen. Paul’s idea considers also allowing nonprofit entities such as churches and alumni associations to offer insurance coverage to members. But Cuban emphasized that the product, not the retail outlet, is the main problem — asserting that whether the insurance purchase is made through Amazon, a church, or the ACA marketplace, the product is still provided by unaccountable insurance giants.]
Cuban added: “The big insurance carriers will not only do what they do today, they will create more information asymmetry for the associations and retailers than what we see today. Which will allow them to do more of all the [expletive] up things they do today.
“The ACA has failed because you and your peers, on both sides, did nothing to stop insurance carriers and hospital networks from becoming the behemoths they are today. They will continue to underpay or no pay everyone they can.
“They will continue to use their PBMs to rip off patients. Do you really think they will all of the sudden make their PBMs honest when they sell through Costco , Amazon, Home Depot , whoever ? Hell no. They will make it worse.
“I’m all for ending state line restrictions. Allowing docs to start own hospitals But you have to recognize the current market is not efficient. Not close at all Which allows the behemoths, carriers and hospital networks to be economically abusive. Get the DOJ and FTC to look at breaking up these enormous companies , and then you might have some real , transparent competition that benefits from consumers shopping for themselves.”
An X user shared an interview of Sen. Roger Marshall (R-KS), who is also a physician, saying “we do need some type of reinsurance pool to take care of the high risk people. We would like to have association healthcare plans so Amazon or Costco, someone like that, could sell health plans across state plans.”
Cuban replied again, writing: “I’ll say it again. If you sell plans from the same insurance carriers that sell med advantage or ACA plans through Amazon or Costco or anywhere else , what exactly do you expect to change ? Nothing. It will be the same garbage.”
I’ll say it again. If you sell plans from the same insurance carriers that sell med advantage or ACA plans through Amazon or Costco or anywhere else , what exactly do you expect to change ?
Nothing. It will be the same garbage.
It’s not like going to Starbucks and you pick… https://t.co/EICNeY2sbj
— Mark Cuban (@mcuban) December 4, 2025
Cuban continued: “It’s not like going to Starbucks and you pick from a menu. ‘Do you want your deductible to be $5000 or $10000 ? Would you like a lower premium with that , say $600 dollars ?’ Hell No. They have to set their plans. Maybe they add a single 10k deductible , lower premium plan. And guess what …
“Customer ‘how much is your commission on this plan ?’ ‘I want choices, why are there only 3 plans i can choose from?’ ‘Excuse me Costco insurance rep, can you promise me they won’t remove my doctor from their network’ ‘if I find a lower cash price somewhere else, will it count against my deductible?’ ‘ speaking of deductibles, will you charge me the full retail price for my branded meds during my deductible phase and keep the rebate? Or do I pay the net price at my pharmacy? And does my pharmacy lose money?’ ‘What happens if I can’t afford my deductible?’ ‘why do I when to buy from your specialty pharmacy? It’s more expensive ‘
“GTFO. It will be THE EXACT SAME GARBAGE consumers get today. Or worse.
“Why worse? Because they know the insurance clerk at the retail store isn’t going to spend hours exposing options. They will be thinking. ‘Always Be Closing ‘ They know retail customers will get less info than today and opacity and info asymmetry is a gold mine for them.”
Doug Stafford, Senator Paul’s Chief Strategist, replied to Cuban: “That’s not what AHP plans do, and we would be happy to discuss it more if you’d like. It has nothing to do with a clerk at a retail store. It’s about large buying groups leveraging their numbers to have plans that are cheaper, better and more varied. Small business becomes as powerful as large business. Individuals become as powerful as government plans, by buying through trade associations or professional groups. It works best with other reforms such as larger HSA, price transparency and many other things, but it’s an operant piece of done and understood correctly, DM if you’d want to speak to Senator Paul about it we can do that anytime.”
Entrepreneur Jeremy Chrysler (whom Cuban follows on X) replied to Stafford: “Reinsurance can be a very powerful tool for reducing premiums. Big problem is insurance tries to do too much. it’s like if car insurance covered everything from floor mats to natural disasters. Alaska reinsurance plan reduced premiums by 40%.”