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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Sep. 30, 2021
Sep. 30, 2020
Dec. 31, 2020
Segment Reporting Information [Line Items]          
Total revenue $ 7,040 $ 5,021 $ 20,362 $ 14,188  
Total 915   915   $ 941
Less: other operating expenses (6,819) (4,732) (19,533) (13,201)  
Operating income 221 289 829 987  
Other expenses, net 30 27 90 77  
Income before income tax expense 191 262 739 910  
Medicaid          
Segment Reporting Information [Line Items]          
Total revenue 5,354 3,996 15,583 11,124  
Goodwill 387   387   378
Intangible assets, net 135   135   157
Medicare          
Segment Reporting Information [Line Items]          
Total revenue 875 636 2,502 1,909  
Goodwill 247   247   247
Intangible assets, net 65   65   76
Marketplace          
Segment Reporting Information [Line Items]          
Total revenue 793 389 2,224 1,155  
Other          
Segment Reporting Information [Line Items]          
Total revenue 18 0 53 0  
Goodwill 67   67   67
Intangible assets, net 14   14   $ 16
Operating segments          
Segment Reporting Information [Line Items]          
Total margin 755 670 2,358 2,032  
Operating segments | Medicaid          
Segment Reporting Information [Line Items]          
Total margin 532 509 1,687 1,427  
Operating segments | Medicare          
Segment Reporting Information [Line Items]          
Total margin 151 91 329 333  
Operating segments | Marketplace          
Segment Reporting Information [Line Items]          
Total margin 68 70 331 272  
Operating segments | Other          
Segment Reporting Information [Line Items]          
Total margin 4 0 11 0  
Other operating          
Segment Reporting Information [Line Items]          
Total revenue 222 253 620 744  
Less: other operating expenses $ (756) $ (634) $ (2,149) $ (1,789)