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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2020
Dec. 31, 2019
Dec. 31, 2018
Operating activities:      
Net income $ 673 $ 737 $ 707
Adjustments to reconcile net income to net cash provided by (used in) operating activities:      
Depreciation and amortization 88 89 127
Deferred income taxes (19) 10 (6)
Share-based compensation 57 39 27
Loss (gain) on debt repayment 15 (15) 22
Loss on sales of subsidiaries, net of gain 0 0 15
Non-cash restructuring charges 0 0 17
Other, net 12 0 26
Changes in operating assets and liabilities, net of the effect of acquisitions:      
Receivables (100) (76) (530)
Prepaid expenses and other current assets (16) 28 6
Medical claims and benefits payable 544 (107) (226)
Amounts due government agencies 446 (303) (574)
Accounts payable, accrued liabilities and other 78 2 45
Deferred revenue 126 38 (21)
Income taxes (14) (15) 51
Net cash provided by operating activities 1,890 427 (314)
Investing activities:      
Purchases of investments (670) (2,536) (1,444)
Proceeds from sales and maturities of investments 1,097 2,302 2,445
Purchases of property, equipment and capitalized software (74) (57) (30)
Net cash paid in business combinations (755) 0 0
Net cash received from sale of subsidiaries 0 0 190
Other, net 2 (2) (18)
Net cash (used in) provided by investing activities (400) (293) 1,143
Financing activities:      
Proceeds from senior notes offerings, net of issuance costs 1,429 0 0
Common stock purchases (606) (47) 0
Repayment of term loan facility (600) 0 0
Proceeds from borrowings under term loan facility 380 220 0
Repayment of senior notes (338) 0 0
Cash paid for partial termination of warrants (30) (514) (549)
Cash paid for partial settlement of conversion option (27) (578) (623)
Cash received for partial settlement of call option 27 578 623
Repayment of principal amount of convertible senior notes (12) (240) (362)
Repayment of credit facility 0 0 (300)
Other, net 2 29 18
Net cash provided by (used in) financing activities 225 (552) (1,193)
Net increase (decrease) in cash and cash equivalents, and restricted cash and cash equivalents 1,715 (418) (364)
Cash and cash equivalents, and restricted cash and cash equivalents at beginning of period 2,508 2,926 3,290
Cash and cash equivalents, and restricted cash and cash equivalents at end of period 4,223 2,508 2,926
Cash paid during the period for:      
Income taxes 321 239 240
Interest 112 78 93
Schedule of non-cash investing and financing activities:      
Fair value of assets acquired (1,340) 0 0
Fair value of contingent consideration liabilities 40 0 0
Fair value of liabilities assumed 545 0 0
Net cash paid in business combinations (755) 0 0
Convertible senior notes exchange transaction:      
Common stock issued in exchange for convertible senior notes 0 0 131
Component of convertible senior notes allocated to additional paid-in capital, net of income taxes 0 0 (23)
Net increase to additional paid-in capital 0 0 108
Common stock used for stock-based compensation (8) (7) (6)
Common stock purchases not settled at end of period 6 7 0
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net 0 0 0
Details of sales of subsidiaries:      
Decrease in carrying amount of assets 0 0 (327)
Decrease in carrying amount of liabilities 0 0 85
Transaction costs 0 0 (15)
Cash received from buyers 0 0 242
Loss on sale of subsidiaries, net of gain 0 0 (15)
(Loss) gain on call option      
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net (2) 132 577
Gain (loss) on conversion option      
Details of change in fair value of derivatives, net:      
Change in fair value of derivatives, net $ 2 $ (132) $ (577)