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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2017
Dec. 31, 2016
Dec. 31, 2015
Operating activities:      
Net (loss) income $ (512) $ 52 $ 143
Adjustments to reconcile net (loss) income to net cash provided by operating activities:      
Depreciation and amortization 178 182 126
Impairment losses 470 0 0
Deferred income taxes (94) 22 (7)
Share-based compensation 46 26 23
Non-cash restructuring charges 60 0 0
Amortization of convertible senior notes and lease financing obligations 32 31 30
Loss on debt extinguishment 14 0 0
Other, net 21 16 19
Changes in operating assets and liabilities:      
Receivables 103 (348) 56
Prepaid expenses and other current assets (56) (69) (35)
Medical claims and benefits payable 263 226 482
Amounts due government agencies 341 473 202
Accounts payable and accrued liabilities (12) (4) 84
Deferred revenue (34) 92 24
Income taxes (16) (26) (22)
Net cash provided by operating activities 804 673 1,125
Investing activities:      
Purchases of investments (2,718) (1,929) (1,923)
Proceeds from sales and maturities of investments 1,771 1,966 1,126
Purchases of property, equipment and capitalized software (86) (176) (132)
(Increase) decrease in restricted investments held-to-maturity (12) 4 (6)
Net cash paid in business combinations 0 (48) (450)
Other, net (28) (19) (35)
Net cash used in investing activities (1,073) (202) (1,420)
Financing activities:      
Proceeds from senior notes offerings, net of issuance costs 325 0 689
Proceeds from borrowings under credit facility 300 0 0
Proceeds from common stock offering, net of issuance costs 0 0 373
Proceeds from employee stock plans 19 18 18
Cash paid for financing transaction fees (7) 0 0
Other, net (1) 1 5
Net cash provided by financing activities 636 19 1,085
Net increase in cash and cash equivalents 367 490 790
Cash and cash equivalents at beginning of period 2,819 2,329 1,539
Cash and cash equivalents at end of period 3,186 2,819 2,329
Supplemental cash flow information:      
Income taxes 7 153 197
Interest 78 66 38
Schedule of non-cash investing and financing activities:      
Issuance of common stock in exchange for 1.625% Convertible Notes 193 0 0
Component of 1.625% Convertible Notes allocated to additional paid-in capital, net of income taxes (32) 0 0
Net increase to additional paid-in capital 161 0 0
Common stock used for stock-based compensation (22) (8) (15)
Details of business combinations:      
Fair value of assets acquired 0 (186) (389)
Fair value of liabilities assumed 0 28 41
Payable to seller 0 8 0
Amounts advanced for acquisitions 0 102 (102)
Net cash paid in business combinations 0 (48) (450)
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net 0 0 0
1.125% Call Option      
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net 255 (107) 45
1.125% Conversion Option      
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net $ (255) $ 107 $ (45)