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Income Taxes (Tables)

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

Schedule of Provision for Income Taxes

The provision for income taxes consists of the following (dollars in millions):

		2022				2021				2020
Current:
Federal		$	1,222			$	1,769			$	1,021
State			206				311				126
Foreign			18				15				5
Deferred:
Federal			261				24				(73	)
State			27				(18	)			(39	)
Foreign			12				11				3
		$	1,746			$	2,112			$	1,043

Schedule of Reconciliation of Federal Statutory Rate to Effective Income Tax Rate

A reconciliation of the federal statutory rate to the effective income tax rate follows:

		2022				2021				2020
Federal statutory rate			21.0	%			21.0	%			21.0	%
State income taxes, net of federal tax benefit			2.3				2.0				1.9
Change in liability for uncertain tax positions			0.7				0.7				(0.2	)
Tax benefit from settlements of employee equity awards			(0.9	)			(1.2	)			(1.8	)
Other items, net			0.5				0.8				0.8
Effective income tax rate on income attributable to HCA Healthcare, Inc.			23.6				23.3				21.7
Income attributable to noncontrolling interests from consolidated partnerships			(3.3	)			(1.8	)			(2.5	)
Effective income tax rate on income before income taxes			20.3	%			21.5	%			19.2	%

Schedule of Deferred Tax Assets and Liabilities

A summary of the items comprising our deferred tax assets and liabilities at December 31 follows (dollars in millions):

		2022								2021
		Assets				Liabilities				Assets				Liabilities
Depreciation and fixed asset basis differences		$	—			$	938			$	—			$	737
Allowances for professional liability and other risks			430								426				—
Accounts receivable			368								348				—
Compensation			402								502				—
Right-of-use lease assets and obligations			451				438				428				419
Other			536				698				499				652
		$	2,187			$	2,074			$	2,203			$	1,808

Schedule of Activity Related to our Gross Unrecognized Tax Benefits

The following table summarizes the activity related to our gross unrecognized tax benefits, excluding accrued interest of $129 million and $99 million as of December 31, 2022 and 2021, respectively (dollars in millions):

		2022				2021
Balance at January 1		$	576			$	469
Additions based on tax positions related to the current year			25				57
Additions for tax positions of prior years			50				66
Reductions for tax positions of prior years			(4	)			(6	)
Settlements			(1	)			(3	)
Lapse of applicable statutes of limitations			(7	)			(7	)
Balance at December 31		$	639			$	576

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Tabular disclosure of the components of income tax expense attributable to continuing operations for each year presented including, but not limited to: current tax expense (benefit), deferred tax expense (benefit), investment tax credits, government grants, the benefits of operating loss carryforwards, tax expense that results from allocating certain tax benefits either directly to contributed capital or to reduce goodwill or other noncurrent intangible assets of an acquired entity, adjustments of a deferred tax liability or asset for enacted changes in tax laws or rates or a change in the tax status of the entity, and adjustments of the beginning-of-the-year balances of a valuation allowance because of a change in circumstances that causes a change in judgment about the realizability of the related deferred tax asset in future years.

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Tabular disclosure of the components of net deferred tax asset or liability recognized in an entity's statement of financial position, including the following: the total of all deferred tax liabilities, the total of all deferred tax assets, the total valuation allowance recognized for deferred tax assets.

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Tabular disclosure of the reconciliation using percentage or dollar amounts of the reported amount of income tax expense attributable to continuing operations for the year to the amount of income tax expense that would result from applying domestic federal statutory tax rates to pretax income from continuing operations.

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Tabular disclosure of the change in unrecognized tax benefits.

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