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Mark Cuban says your 401(k) is part of the healthcare problem

Mark Cuban has a habit of saying things that make people uncomfortable. His latest target is not a specific executive or a federal policy. It is your retirement account.

In a post on X, Cuban argued that anyone whose retirement fund holds shares of the biggest health insurance companies is financially propping up the industry he has spent years criticizing.

“If you own shares in a fund that owns any of the biggest insurance carriers, you are part of the cost of health care problem in this country,” he wrote. He urged investors to pressure the funds they own to dump those positions.

Most workers are not picking individual insurance stocks. They are in index funds. And index funds, almost by design, own major health insurers. That is the tension Cuban is putting on the table.

62% of Americans own healthcare stocks without knowing it

About 62% of Americans own stocks directly or indirectly, according to Gallup research. Most of them are not buying shares of UnitedHealth Group or CVS Health on their own. They are contributing each month to a target-date fund at work, or an S&P 500 index fund, or a total-market fund. Those vehicles hold large-cap companies across every sector. The biggest health insurers are large-cap companies. The math is straightforward.

Also read: Mark Cuban just picked a fight that goes beyond his usual beat

The healthcare sector represents roughly 10% of the S&P 500 by weight. That includes insurers, but also drugmakers, device manufacturers and hospital systems. Cuban’s call to divest is aimed specifically at the largest insurance carriers, not the entire sector. The distinction matters when you start thinking about what to do.

Cuban has argued that publicly traded health insurers prioritize share prices over patients, families and workers. He built Cost Plus Drugs specifically to undercut pharmacy pricing. His position on the broader system is not new. What is new is pointing the finger directly at retirement savers.

What a typical 401(k) actually holds

Employer-sponsored plans typically offer a short menu of funds, not open brokerage accounts where you pick individual stocks. Choose from that menu and you are almost certainly going to end up in a broad index fund. S&P 500 trackers, total-market funds, and target-date funds all buy the entire market. There is no checkbox to remove a single company from the mix. Whatever is in the index is in your account.

Target-date funds work the same way. They hold equities, bonds and other assets in proportions that shift as the target year approaches. Within the equity sleeve, you will usually find full market exposure, including healthcare.

Cuban’s point is not that having a 401(k) is wrong. It is that most workers have never looked at what their fund actually holds. A worker who wants lower premiums and a more transparent billing system may be unknowingly benefiting every time the insurers in their fund post a strong earnings quarter. That conflict is real, even if it is not intentional.

Mark Cuban has a habit of saying things that make people uncomfortable. His latest target is not a specific executive or a federal policy. It is your retirement account.

Halfpoint Images / Getty Images

Options for investors who want out of insurance stocks

Not every 401(k) plan offers ESG or socially responsible fund options. Whether yours does depends on what your employer negotiated with the plan provider. If those options exist, the screening criteria vary and the fund name does not always tell you much.

A fund marketed as healthcare-conscious might exclude tobacco or weapons but still hold stakes in hospital chains and device manufacturers. Before switching, pull up the actual holdings list and read it. The expense ratio will usually be higher than that of a plain index fund, too.

Outside of a 401(k), you have more flexibility. Individual stocks and specialized ETFs let you build around specific companies. That adds concentration risk. Narrowing any portfolio does.

A third option Cuban specifically named is shareholder engagement. If you own shares in a fund, you have voting rights. You can vote against executive compensation packages, support shareholder proposals on pricing transparency or submit your own proposals. That is a slower lever, but it is a real one. Shareholder voting is one of the tools Cuban said investors are not using enough.

The broader cost problem Cuban keeps coming back to

The average annual cost of employer-sponsored family health coverage reached $28,303 in 2026, up 5% from the prior year, according to KFF. Workers paid $7,471 of that on average. Cuban’s argument is that those costs ripple into hiring decisions, wages, and benefit cuts. When companies spend more on premiums, there is less available for raises or new positions.

More Healthcare/Health:

Americans spent $14,775 per person on healthcare in 2024, compared with $7,860 on average across comparable high-income countries, according to the Peterson-KFF Health System Tracker. Cuban has framed publicly traded insurers as a driver of that gap. Their business model is built around generating returns for shareholders, he argues, not minimizing patient costs.

The broader argument is that healthcare spending does not stay inside the healthcare system. It affects wages, hiring, retirement security and consumer prices. Cuban’s case is that investors have more leverage over that dynamic than they realize, and most of them are not using it.

What this actually means for your retirement account

Stopping contributions or cashing out a 401(k) over this would not make financial sense for most workers. The employer match alone is compensation you have earned and would forfeit. On top of that, you lose the tax deferral on decades of future contributions. That is a significant amount to give up over an indirect ownership stake in one insurance company. Cuban has not suggested people should do it.

What Cuban is actually arguing for is informed ownership. Know what your fund holds. If your plan offers a values-based option that fits your situation, understand its fees and actual holdings before you switch. Use whatever shareholder tools your fund manager makes available. A fee-only financial advisor can help you run the numbers before you make any changes.

The practical question is whether your portfolio reflects your financial goals and your values. For most workers, the answer involves staying invested and adjusting around the edges rather than overhauling the account. Cuban’s argument is worth taking seriously. It is also worth understanding what it does and does not require you to do.

Related: Mark Cuban just sent a strong message to America’s workers

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