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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions | 12 Months Ended
--- | ---
Dec. 31, 2025 | Dec. 31, 2024 | Dec. 31, 2023
Cash flows from operating activities: |  |  |
Net earnings (loss) | $ (6,677) | $ 3,294 | $ 2,699
Adjustments to reconcile net earnings (loss) to net cash provided by operating activities |  |  |
Depreciation and amortization | 1,275 | 1,241 | 1,293
Stock compensation expense | 204 | 212 | 216
Impairment | 7,311 | 13 | 529
(Gain) on debt extinguishment | (1) | 0 | 0
Deferred income taxes | (60) | 13 | (78)
(Gain) loss on divestitures, net | (2) | (120) | (152)
Changes in assets and liabilities |  |  |
Premium and trade receivables | 1,480 | (4,333) | (2,380)
Other assets | (230) | 46 | 5
Medical claims liabilities | 2,336 | 368 | 1,261
Unearned revenue | 80 | (54) | 238
Accounts payable and accrued expenses | (657) | (528) | 3,398
Other long-term liabilities | (46) | (70) | 856
Other operating activities, net | 75 | 72 | 168
Net cash provided by operating activities | 5,088 | 154 | 8,053
Cash flows from investing activities: |  |  |
Capital expenditures | (767) | (644) | (799)
Purchases of investments | (4,541) | (7,183) | (6,622)
Sales and maturities of investments | 5,780 | 5,785 | 5,523
Divestiture proceeds, net of divested cash | 0 | 990 | 707
Net cash provided by (used in) investing activities | 472 | (1,052) | (1,191)
Cash flows from financing activities: |  |  |
Proceeds from long-term debt | 750 | 1,300 | 2,335
Payments and repurchases of long-term debt | (1,895) | (622) | (2,316)
Common stock repurchases | (475) | (3,124) | (1,633)
Proceeds from common stock issuances | 37 | 46 | 44
Purchase of noncontrolling interest | (19) | 0 | (88)
Other financing activities, net | (19) | (6) | 0
Net cash used in financing activities | (1,621) | (2,406) | (1,658)
Effect of exchange rate changes on cash, cash equivalents and restricted cash | 0 | 8 | (32)
Net increase (decrease) in cash, cash equivalents and restricted cash and cash equivalents | 3,939 | (3,296) | 5,172
Cash and cash equivalents reclassified (to) from held for sale | (138) | 0 | (50)
Cash, cash equivalents and restricted cash and cash equivalents, beginning of period | 14,156 | 17,452 | 12,330
Cash, cash equivalents and restricted cash and cash equivalents, end of period | 17,957 | 14,156 | 17,452
Supplemental disclosures of cash flow information: |  |  |
Interest paid | 647 | 688 | 688
Income taxes paid, net | 448 | 1,002 | 887
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 | 17,888 | 14,063 | 17,193
Restricted cash and cash equivalents, included in restricted deposits | 69 | 93 | 259
Total cash, cash equivalents, and restricted cash and cash equivalents | $ 17,957 | $ 14,156 | $ 17,452

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