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Income Taxes - Reconciliation Of The Tax Provision At The U.S. Federal Statutory Rate To The Provision For Income Taxes (Details) - USD ($) $ in Millions | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Income Tax Disclosure [Abstract] |  |  |
Earnings from operations, before income tax expense | $ 1,368 | $ 1,134 | $ 1,160
Loss (earnings) attributable to flow through noncontrolling interest | 4 | 15 | (8)
Earnings from operations, less noncontrolling interest, before income tax expense | 1,372 | 1,149 | 1,152
Tax provision at the U.S. federal statutory rate | 288 | 402 | 402
State income taxes, net of federal income tax benefit | 52 | 11 | 10
Nondeductible compensation | 33 | 58 | 23
ACA Health Insurer Fee | 149 | 0 | 162
Income Tax Reform | 0 | (125) | 0
Valuation Allowance | (28) | 14 | 10
Other, net | (20) | (34) | (8)
Income tax expense | $ 474 | $ 326 | $ 599

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- Definition Amount of income (loss) from continuing operations before deduction of income tax expense (benefit) and income (loss) attributable to noncontrolling interest, and addition of income (loss) from equity method investments. + 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)(1)(i)) -URI http://asc.fasb.org/extlink&oid=26873400&loc=d3e23780-122690 + Details
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