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Income Taxes - Deferred Tax Assets and Liabilities (Details) - USD ($) $ in Millions | Dec. 31, 2018 | Dec. 31, 2017
--- | --- | ---
Significant components of deferred tax assets and liabilities |  |
Accrued expenses | $ 32 | $ 15
Reserve liabilities | 7 | 11
Other accrued medical costs | 12 | 16
Net operating losses | 16 | 27
Fixed assets and intangibles | 30 | 23
Unearned premiums | 9 | 19
Lease financing obligation | 30 | 30
Tax credit carryover | 12 | 15
Other | 3 | 3
Valuation allowance | (28) | (41)
Total deferred income tax assets, net of valuation allowance | 123 | 118
Prepaid expenses | (6) | (6)
Basis in debt | 0 | (9)
Total deferred income tax liabilities | (6) | (15)
Net deferred income tax asset | $ 117 | $ 103

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