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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Operating activities:    
Net income $ 556 $ 639
Adjustments to reconcile net income to net cash provided by operating activities:    
Depreciation and amortization 96 64
Deferred income taxes (8) (3)
Share-based compensation 49 43
Loss on debt repayment 0 5
Other, net 9 2
Changes in operating assets and liabilities:    
Receivables (247) (369)
Prepaid expenses and other current assets (43) (98)
Medical claims and benefits payable 522 431
Amounts due government agencies 810 (24)
Accounts payable, accrued liabilities and other 129 63
Deferred revenue (374) (188)
Income taxes 23 34
Net cash provided by operating activities 1,522 599
Investing activities:    
Purchases of investments (2,018) (670)
Proceeds from sales and maturities of investments 965 891
Purchases of property, equipment and capitalized software (56) (64)
Net cash paid in business combinations 0 (62)
Other, net 3 3
Net cash (used in) provided by investing activities (1,106) 98
Financing activities:    
Common stock purchases (128) (453)
Common stock withheld to settle employee tax obligations (52) (8)
Contingent consideration liabilities settled (20) 0
Proceeds from senior notes offering, net of issuance costs 0 789
Repayment of term loan facility 0 (600)
Proceeds from borrowings under term loan facility 0 380
Other, net (4) (47)
Net cash (used in) provided by financing activities (204) 61
Net increase in cash, cash equivalents, and restricted cash and cash equivalents 212 758
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period 4,223 2,508
Cash, cash equivalents, and restricted cash and cash equivalents at end of period $ 4,435 $ 3,266