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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2021
Mar. 31, 2020
Dec. 31, 2020
Segment Reporting Information [Line Items]      
Total revenue $ 6,522 $ 4,549  
Total 923   $ 941
Less: other operating expenses (6,187) (4,275)  
Operating income 335 274  
Other expenses, net 30 21  
Income before income tax expense 305 253  
Medicaid      
Segment Reporting Information [Line Items]      
Total revenue 5,020 3,517  
Goodwill 372   378
Intangible assets, net 150   157
Medicare      
Segment Reporting Information [Line Items]      
Total revenue 805 639  
Goodwill 247   247
Intangible assets, net 72   76
Marketplace      
Segment Reporting Information [Line Items]      
Total revenue 680 393  
Other      
Segment Reporting Information [Line Items]      
Total revenue 17 0  
Goodwill 67   67
Intangible assets, net 15   $ 16
Operating segments      
Segment Reporting Information [Line Items]      
Total margin 836 588  
Operating segments | Medicaid      
Segment Reporting Information [Line Items]      
Total margin 604 365  
Operating segments | Medicare      
Segment Reporting Information [Line Items]      
Total margin 77 117  
Operating segments | Marketplace      
Segment Reporting Information [Line Items]      
Total margin 151 106  
Operating segments | Other      
Segment Reporting Information [Line Items]      
Total margin 4 0  
Other operating      
Segment Reporting Information [Line Items]      
Total revenue 199 245  
Less: other operating expenses $ (700) $ (559)