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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Operating activities:      
Net income $ 792 $ 659 $ 673
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 176 131 88
Deferred income taxes (66) (24) (19)
Share-based compensation 103 72 57
Loss on debt repayment 0 25 15
Impairment 208 0 0
Other, net 8 33 12
Changes in operating assets and liabilities, net of the effect of acquisitions:      
Receivables (95) (415) (100)
Prepaid expenses and other current assets (124) (19) (16)
Medical claims and benefits payable 153 471 544
Amounts due government agencies (428) 1,046 446
Accounts payable, accrued liabilities and other 55 138 86
Deferred revenue (11) (5) 126
Income taxes 2 7 (14)
Net cash provided by operating activities 773 2,119 1,898
Investing activities:      
Purchases of investments (1,913) (2,713) (670)
Proceeds from sales and maturities of investments 1,398 1,329 1,097
Net cash paid in business combinations (134) (129) (755)
Purchases of property, equipment and capitalized software (91) (77) (74)
Other, net (50) (63) 2
Net cash provided by (used in) investing activities (790) (1,653) (400)
Financing activities:      
Common stock purchases (400) (128) (606)
Common stock withheld to settle employee tax obligations (54) (53) (8)
Contingent consideration liabilities settled (20) (20) 0
Proceeds from senior notes offerings, net of issuance costs 0 740 1,429
Repayment of senior notes 0 (723) (338)
Repayment of term loan facility 0 0 (600)
Proceeds from borrowings under term loan facility 0 0 380
Cash paid for partial termination of warrants 0 0 (30)
Cash paid for partial settlement of conversion option 0 0 (27)
Cash received for partial settlement of call option 0 0 27
Repayment of principal amount of convertible senior notes 0 0 (12)
Other, net 33 1 2
Net cash (used in) provided by financing activities (441) (183) 217
Net (decrease) increase in cash and cash equivalents, and restricted cash and cash equivalents (458) 283 1,715
Cash and cash equivalents, and restricted cash and cash equivalents at beginning of period 4,506 4,223 2,508
Cash and cash equivalents, and restricted cash and cash equivalents at end of period 4,048 4,506 4,223
Cash paid during the period for:      
Income taxes 340 235 321
Interest $ 108 $ 127 $ 112