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Income Taxes - Effective Tax Rate Reconciliation (Details) | 12 Months Ended
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Dec. 31, 2019 | Dec. 31, 2018 | Dec. 31, 2017
Effective Income Tax Rate Reconciliation, Amount [Abstract] |  |  |
Statutory income tax rate | 21.00% | 21.00% | 35.00%
State income taxes, net of federal tax benefit | 4.00% | 27.70% | 4.10%
Effect of the Tax Cuts and Jobs Act | 0 | (0.071) | (0.183)
Health insurer fee | 0.00% | 2.20% | 0.00%
Goodwill impairments | 0.00% | 89.50% | 0.80%
Sale of subsidiary | 0.00% | 5.00% | 0.00%
Other | 1.30% | 4.10% | (1.80%)
Effective income tax rate | 26.30% | 142.40% | 19.80%

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- Definition Percentage of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 235 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SX 210.4-08.(h)(2)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32698-109319 + Details
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- Definition Percentage of domestic federal statutory tax rate applicable to pretax income (loss). + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SAB TOPIC 6.I) -URI http://asc.fasb.org/extlink&oid=116825942&loc=d3e330036-122817 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32698-109319 + Details
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- Definition Percentage of the difference between reported income tax expense (benefit) and expected income tax expense (benefit) computed by applying the domestic federal statutory income tax rates to pretax income (loss) from continuing operations attributable to disposition of a business not qualifying as a discontinued operation. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 12 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32687-109319 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section S99 -Paragraph 1 -Subparagraph (SAB TOPIC 6.I) -URI http://asc.fasb.org/extlink&oid=116825942&loc=d3e330036-122817 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 740 -SubTopic 10 -Section 50 -Paragraph 13 -URI http://asc.fasb.org/extlink&oid=84230637&loc=d3e32698-109319 + Details
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