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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2022
Mar. 31, 2021
Segment Reporting Information [Line Items]    
Add: other operating revenues $ 7,770 $ 6,522
Less: other operating expenses (7,398) (6,187)
Operating income 372 335
Other expenses, net 28 30
Income before income tax expense 344 305
Medicaid    
Segment Reporting Information [Line Items]    
Add: other operating revenues 6,187 5,020
Medicare    
Segment Reporting Information [Line Items]    
Add: other operating revenues 949 805
Marketplace    
Segment Reporting Information [Line Items]    
Add: other operating revenues 616 680
Other    
Segment Reporting Information [Line Items]    
Add: other operating revenues 18 17
Operating segments    
Segment Reporting Information [Line Items]    
Total margin 971 836
Operating segments | Medicaid    
Segment Reporting Information [Line Items]    
Total margin 710 604
Operating segments | Medicare    
Segment Reporting Information [Line Items]    
Total margin 128 77
Operating segments | Marketplace    
Segment Reporting Information [Line Items]    
Total margin 130 151
Operating segments | Other    
Segment Reporting Information [Line Items]    
Total margin 3 4
Other operating    
Segment Reporting Information [Line Items]    
Add: other operating revenues 221 199
Less: other operating expenses $ (820) $ (700)