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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended 6 Months Ended
Jun. 30, 2021
Jun. 30, 2020
Jun. 30, 2021
Jun. 30, 2020
Dec. 31, 2020
Segment Reporting Information [Line Items]          
Total revenue $ 6,800 $ 4,618 $ 13,322 $ 9,167  
Total 929   929   $ 941
Less: other operating expenses (6,527) (4,194) (12,714) (8,469)  
Operating income 273 424 608 698  
Other expenses, net 30 29 60 50  
Income before income tax expense 243 395 548 648  
Medicaid          
Segment Reporting Information [Line Items]          
Total revenue 5,209 3,611 10,229 7,128  
Goodwill 390   390   378
Intangible assets, net 143   143   157
Medicare          
Segment Reporting Information [Line Items]          
Total revenue 822 634 1,627 1,273  
Goodwill 247   247   247
Intangible assets, net 68   68   76
Marketplace          
Segment Reporting Information [Line Items]          
Total revenue 751 373 1,431 766  
Other          
Segment Reporting Information [Line Items]          
Total revenue 18 0 35 0  
Goodwill 67   67   67
Intangible assets, net 14   14   $ 16
Operating segments          
Segment Reporting Information [Line Items]          
Total margin 767 774 1,603 1,362  
Operating segments | Medicaid          
Segment Reporting Information [Line Items]          
Total margin 551 553 1,155 918  
Operating segments | Medicare          
Segment Reporting Information [Line Items]          
Total margin 101 125 178 242  
Operating segments | Marketplace          
Segment Reporting Information [Line Items]          
Total margin 112 96 263 202  
Operating segments | Other          
Segment Reporting Information [Line Items]          
Total margin 3 0 7 0  
Other operating          
Segment Reporting Information [Line Items]          
Total revenue 199 246 398 491  
Less: other operating expenses $ (693) $ (596) $ (1,393) $ (1,155)