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Investments (Notes)
 12 Months Ended
Dec. 31, 2024
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, 2024
Debt securities - available-for-sale:
U.S. government and agency obligations$4,600 $1 $(274)$4,327 
State and municipal obligations7,357 2 (375)6,984 
Corporate obligations24,391 56 (1,140)23,307 
U.S. agency mortgage-backed securities10,577 1 (994)9,584 
Non-U.S. agency mortgage-backed securities2,890 2 (175)2,717 
Total debt securities - available-for-sale49,815 62 (2,958)46,919 
Debt securities - held-to-maturity:
U.S. government and agency obligations444 — (2)442 
State and municipal obligations28 — (2)26 
Corporate obligations40 — — 40 
Total debt securities - held-to-maturity512 — (4)508 
Total debt securities$50,327 $62 $(2,962)$47,427 
December 31, 2023
Debt securities - available-for-sale:
U.S. government and agency obligations$4,674 $3 $(234)$4,443 
State and municipal obligations7,636 39 (322)7,353 
Corporate obligations23,136 67 (1,186)22,017 
U.S. agency mortgage-backed securities8,982 22 (708)8,296 
Non-U.S. agency mortgage-backed securities3,023 3 (240)2,786 
Total debt securities - available-for-sale47,451 134 (2,690)44,895 
Debt securities - held-to-maturity:
U.S. government and agency obligations506 1 (6)501 
State and municipal obligations28 — (2)26 
Corporate obligations69 — — 69 
Total debt securities - held-to-maturity603 1 (8)596 
Total debt securities$48,054 $135 $(2,698)$45,491 
Nearly all of the Company’s investments in mortgage-backed securities were rated “Double A” or better as of December 31, 2024.
The Company held $4.9 billion of equity securities as of December 31, 2024 and 2023. The Company’s investments in equity securities primarily consist of venture investments and employee savings plan related investments. Additionally, the Company’s investments included $3.8 billion and $1.4 billion of equity method investments primarily in operating businesses in the health care sector, as of December 31, 2024 and 2023, respectively. The allowance for credit losses on held-to-maturity securities as of December 31, 2024 and 2023 was not material.
The amortized cost and fair value of debt securities as of December 31, 2024, 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$3,952 $3,932 $320 $319 
Due after one year through five years14,845 14,384 161 161 
Due after five years through ten years12,110 11,213 14 13 
Due after ten years5,441 5,089 17 15 
U.S. agency mortgage-backed securities10,577 9,584 — — 
Non-U.S. agency mortgage-backed securities2,890 2,717 — — 
Total debt securities$49,815 $46,919 $512 $508 
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, 2024
U.S. government and agency obligations$1,475 $(51)$2,152 $(223)$3,627 $(274)
State and municipal obligations2,593 (58)4,085 (317)6,678 (375)
Corporate obligations7,402 (213)11,449 (927)18,851 (1,140)
U.S. agency mortgage-backed securities
4,791 (191)4,674 (803)9,465 (994)
Non-U.S. agency mortgage-backed securities
416 (5)1,863 (170)2,279 (175)
Total debt securities - available-for-sale$16,677 $(518)$24,223 $(2,440)$40,900 $(2,958)
December 31, 2023
U.S. government and agency obligations$1,270 $(7)$2,077 $(227)$3,347 $(234)
State and municipal obligations907 (7)4,063 (315)4,970 (322)
Corporate obligations1,826 (17)14,696 (1,169)16,522 (1,186)
U.S. agency mortgage-backed securities
1,337 (12)5,069 (696)6,406 (708)
Non-U.S. agency mortgage-backed securities
279 (6)2,202 (234)2,481 (240)
Total debt securities - available-for-sale$5,619 $(49)$28,107 $(2,641)$33,726 $(2,690)
The Company’s unrealized losses from all securities as of December 31, 2024 were generated from approximately 34,000 positions out of a total of 43,000 positions. The Company believes it will timely collect the principal and interest due on its debt securities that have 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 collectibility 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, 2024, 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, 2024 and 2023 was not material.