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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2023
Mar. 31, 2022
Segment Reporting Information [Line Items]    
Add: other operating revenues $ 8,149 $ 7,770
Less: other operating expenses (7,694) (7,398)
Operating income 455 372
Other expenses, net 28 28
Income before income tax expense 427 344
Medicaid    
Segment Reporting Information [Line Items]    
Add: other operating revenues 6,578 6,187
Medicare    
Segment Reporting Information [Line Items]    
Add: other operating revenues 1,056 949
Marketplace    
Segment Reporting Information [Line Items]    
Add: other operating revenues 497 616
Other    
Segment Reporting Information [Line Items]    
Add: other operating revenues 18 18
Operating segments    
Segment Reporting Information [Line Items]    
Total margin 1,016 971
Operating segments | Medicaid    
Segment Reporting Information [Line Items]    
Total margin 734 710
Operating segments | Medicare    
Segment Reporting Information [Line Items]    
Total margin 126 128
Operating segments | Marketplace    
Segment Reporting Information [Line Items]    
Total margin 154 130
Operating segments | Other    
Segment Reporting Information [Line Items]    
Total margin 2 3
Other operating    
Segment Reporting Information [Line Items]    
Add: other operating revenues 246 221
Less: other operating expenses $ (807) $ (820)