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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2020
Sep. 30, 2019
Operating activities:    
Net income $ 639 $ 569
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 64 68
Deferred income taxes (3) 7
Share-based compensation 43 29
Loss (gain) on debt repayment 5 (15)
Other, net 2 0
Changes in operating assets and liabilities:    
Receivables (369) 50
Prepaid expenses and other current assets (98) (6)
Medical claims and benefits payable 431 14
Amounts due government agencies (24) (355)
Accounts payable, accrued liabilities and other 55 37
Deferred revenue (188) (4)
Income taxes 34 4
Net cash provided by operating activities 591 398
Investing activities:    
Purchases of investments (670) (1,938)
Proceeds from sales and maturities of investments 891 1,890
Net cash paid in business combinations (62) 0
Purchases of property, equipment and capitalized software (64) (30)
Other, net 3 (2)
Net cash provided by (used in) investing activities 98 (80)
Financing activities:    
Proceeds from senior notes offering, net of issuance costs 789 0
Repayment of term loan facility (600) 0
Common stock purchases (453) 0
Proceeds from borrowings under term loan facility 380 220
Cash paid for partial termination of warrants (30) (514)
Cash paid for partial settlement of conversion option (27) (578)
Cash received for partial settlement of call option 27 578
Repayment of principal amount of convertible senior notes (12) (240)
Other, net (5) 24
Net cash provided by (used in) financing activities 69 (510)
Net increase (decrease) in cash, cash equivalents, and restricted cash and cash equivalents 758 (192)
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period 2,508 2,926
Cash, cash equivalents, and restricted cash and cash equivalents at end of period 3,266 2,734
Schedule of non-cash investing and financing activities:    
Common stock used for share-based compensation (8) (7)
Details of business combinations:    
Fair value of assets acquired (106) 0
Fair value of contingent consideration liabilities 40 0
Fair value of liabilities assumed 4 0
Net cash paid in business combinations 62 0
Details of change in fair value of derivatives, net:    
Change in fair value of derivatives, net 0 0
Call option    
Details of change in fair value of derivatives, net:    
Change in fair value of derivatives, net (2) 124
Conversion option    
Details of change in fair value of derivatives, net:    
Change in fair value of derivatives, net $ 2 $ (124)