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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Cash flows from operating activities:      
Net earnings $ 3,294 $ 2,699 $ 1,202
Adjustments to reconcile net earnings to net cash provided by operating activities      
Depreciation and amortization 1,241 1,293 1,430
Stock compensation expense 212 216 234
Impairment 13 529 2,318
(Gain) loss on debt extinguishment 0 0 (25)
(Gain) on acquisition 0 0 (2)
Deferred income taxes 13 (78) (631)
(Gain) loss on divestitures, net (120) (152) (772)
Loss on disposal of equipment 0 0 221
Other adjustments, net 16 172 (31)
Changes in assets and liabilities      
Premium and trade receivables (4,333) (2,380) (1,627)
Other assets 46 5 128
Medical claims liabilities 368 1,261 2,397
Unearned revenue (54) 238 31
Accounts payable and accrued expenses (528) 3,398 421
Other long-term liabilities (70) 856 842
Other operating activities, net 56 (4) 125
Net cash provided by operating activities 154 8,053 6,261
Cash flows from investing activities:      
Capital expenditures (644) (799) (1,004)
Purchases of investments (7,183) (6,622) (6,736)
Sales and maturities of investments 5,785 5,523 3,802
Acquisitions, net of cash acquired 0 0 (1,460)
Divestiture proceeds, net of divested cash 990 707 2,477
Net cash used in investing activities (1,052) (1,191) (2,921)
Cash flows from financing activities:      
Proceeds from long-term debt 1,300 2,335 360
Payments and repurchases of long-term debt (622) (2,316) (1,490)
Common stock repurchases (3,124) (1,633) (3,096)
Proceeds from common stock issuances 46 44 70
Payments for debt extinguishment 0 0 (14)
Purchase of noncontrolling interest 0 (88) 0
Other financing activities, net (6) 0 (27)
Net cash used in financing activities (2,406) (1,658) (4,197)
Effect of exchange rate changes on cash, cash equivalents and restricted cash 8 (32) (11)
Net increase (decrease) in cash, cash equivalents and restricted cash and cash equivalents (3,296) 5,172 (868)
Cash and cash equivalents reclassified (to) from held for sale 0 (50) (16)
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period 17,452 12,330 13,214
Cash, cash equivalents and restricted cash and cash equivalents, end of period 14,156 17,452 12,330
Supplemental disclosures of cash flow information:      
Interest paid 688 688 657
Income taxes paid, net 1,002 887 1,198
Equity issued in connection with acquisitions 0 0 60
The following table provides a reconciliation of cash, cash equivalents and restricted cash and cash equivalents reported within the Consolidated Balance Sheets to the totals above:      
Cash and cash equivalents 14,063 17,193 12,074
Restricted cash and cash equivalents, included in restricted deposits 93 259 256
Total cash, cash equivalents, and restricted cash and cash equivalents $ 14,156 $ 17,452 $ 12,330