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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2022
Dec. 31, 2021
Dec. 31, 2020
Segment Reporting Information [Line Items]      
Add: Other operating revenues $ 31,974 $ 27,771 $ 19,423
Less: Other operating expenses (30,801) (26,751) (18,345)
Operating income 1,173 1,020 1,078
Less: other expenses, net 110 145 117
Income before income tax expense 1,063 875 961
Medicaid      
Segment Reporting Information [Line Items]      
Total margin 2,981 2,322 1,804
Add: Other operating revenues 25,783 21,231 15,217
Medicare      
Segment Reporting Information [Line Items]      
Total margin 437 430 351
Add: Other operating revenues 3,824 3,379 2,529
Marketplace Segment      
Segment Reporting Information [Line Items]      
Total margin 290 399 324
Add: Other operating revenues 2,296 3,091 1,677
Other      
Segment Reporting Information [Line Items]      
Total margin 11 14 0
Add: Other operating revenues 71 70 0
Operating Segments      
Segment Reporting Information [Line Items]      
Total margin 3,719 3,165 2,479
Other Operating      
Segment Reporting Information [Line Items]      
Add: Other operating revenues 1,020 846 1,124
Less: Other operating expenses $ (3,566) $ (2,991) $ (2,525)