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Investments (Notes)
 12 Months Ended
Dec. 31, 2022
Investments [Abstract]  
Investments [Text Block] Investments
A summary of debt securities by major security type is as follows:
(in millions)Amortized
Cost		Gross
Unrealized
Gains		Gross
Unrealized
Losses		Fair
Value
December 31, 2022
Debt securities - available-for-sale:
U.S. government and agency obligations$4,093 $1 $(285)$3,809 
State and municipal obligations7,702 25 (479)7,248 
Corporate obligations23,675 17 (1,798)21,894 
U.S. agency mortgage-backed securities7,379 15 (808)6,586 
Non-U.S. agency mortgage-backed securities3,077 1 (294)2,784 
Total debt securities - available-for-sale45,926 59 (3,664)42,321 
Debt securities - held-to-maturity:
U.S. government and agency obligations578 — (14)564 
State and municipal obligations29 — (3)26 
Corporate obligations89 — — 89 
Total debt securities - held-to-maturity696 — (17)679 
Total debt securities$46,622 $59 $(3,681)$43,000 
December 31, 2021
Debt securities - available-for-sale:
U.S. government and agency obligations$3,206 $23 $(31)$3,198 
State and municipal obligations6,829 297 (20)7,106 
Corporate obligations20,947 372 (145)21,174 
U.S. agency mortgage-backed securities5,868 88 (55)5,901 
Non-U.S. agency mortgage-backed securities2,819 42 (23)2,838 
Total debt securities - available-for-sale39,669 822 (274)40,217 
Debt securities - held-to-maturity:
U.S. government and agency obligations511 2 (2)511 
State and municipal obligations30 2 — 32 
Corporate obligations100 — — 100 
Total debt securities - held-to-maturity641 4 (2)643 
Total debt securities$40,310 $826 $(276)$40,860 
Nearly all of the Company’s investments in mortgage-backed securities were rated “Triple A” as of December 31, 2022.
The Company held $3.7 billion and $3.5 billion of equity securities as of December 31, 2022 and 2021, respectively. The Company’s investments in equity securities primarily consist of employee savings plan related investments, venture investments and shares of Brazilian real denominated fixed-income funds with readily determinable fair values. Additionally, the Company’s investments included $1.5 billion and $1.3 billion of equity method investments in operating businesses in the health care sector, as of December 31, 2022 and 2021, respectively. The allowance for credit losses on held-to-maturity securities as of December 31, 2022 and 2021 was not material.
The amortized cost and fair value of debt securities as of December 31, 2022, by contractual maturity, were as follows:
Available-for-SaleHeld-to-Maturity
(in millions)Amortized
Cost		Fair
Value		Amortized
Cost		Fair
Value
Due in one year or less$4,713 $4,682 $374 $369 
Due after one year through five years13,135 12,404 265 256 
Due after five years through ten years12,210 10,897 37 36 
Due after ten years5,412 4,968 20 18 
U.S. agency mortgage-backed securities7,379 6,586 — — 
Non-U.S. agency mortgage-backed securities3,077 2,784 — — 
Total debt securities$45,926 $42,321 $696 $679 
The fair value of available-for-sale debt securities with gross unrealized losses by major security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
 Less Than 12 Months12 Months or Greater Total
(in millions)Fair
Value		Gross
Unrealized
Losses		Fair
Value		Gross
Unrealized
Losses		Fair
Value		Gross
Unrealized
Losses
December 31, 2022
U.S. government and agency obligations$2,007 $(96)$1,290 $(189)$3,297 $(285)
State and municipal obligations4,630 (288)1,178 (191)5,808 (479)
Corporate obligations13,003 (893)6,637 (905)19,640 (1,798)
U.S. agency mortgage-backed securities
3,561 (345)2,239 (463)5,800 (808)
Non-U.S. agency mortgage-backed securities
1,698 (128)976 (166)2,674 (294)
Total debt securities - available-for-sale$24,899 $(1,750)$12,320 $(1,914)$37,219 $(3,664)
December 31, 2021
U.S. government and agency obligations$1,976 $(18)$249 $(13)$2,225 $(31)
State and municipal obligations1,386 (19)31 (1)1,417 (20)
Corporate obligations9,357 (130)376 (15)9,733 (145)
U.S. agency mortgage-backed securities
3,078 (52)116 (3)3,194 (55)
Non-U.S. agency mortgage-backed securities
1,321 (18)114 (5)1,435 (23)
Total debt securities - available-for-sale$17,118 $(237)$886 $(37)$18,004 $(274)
The Company’s unrealized losses from all securities as of December 31, 2022 were generated from approximately 35,000 positions out of a total of 41,000 positions. The Company believes it will collect the timely principal and interest due on its debt securities having an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities which impacted the Company’s assessment on collectability of principal and interest. At each reporting period, the Company evaluates available-for-sale debt securities for any credit-related impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the expected cash flows, the underlying credit quality and credit ratings of the issuers noting no significant credit deterioration since purchase. As of December 31, 2022, the Company did not have the intent to sell any of the securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary. The allowance for credit losses on available-for-sale debt securities as of December 31, 2022 and 2021 was not material.