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Segments
 9 Months Ended
Sep. 30, 2023
Segment Reporting [Abstract]  
Segments Segments
We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.
The Medicaid, Medicare, and Marketplace segments represent the government-funded or sponsored programs under which we offer managed healthcare services. The Other segment, which is insignificant to our consolidated results of operations, includes long-term services and supports consultative services in Wisconsin.
The key metrics used to assess the performance of our Medicaid, Medicare, and Marketplace segments are premium revenue, medical margin and medical care ratio (“MCR”). MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying medical margin, or the amount earned by the Medicaid, Medicare, and Marketplace segments after medical costs are deducted from premium revenue, represents the most important measure of earnings reviewed by management, and is used by our chief executive officer to review results, assess performance, and allocate resources. The key metric used to assess the performance of our Other segment is service margin. The service margin is equal to service revenue minus cost of service revenue. We do not report total assets by segment because this is not a metric used to assess segment performance or allocate resources.
The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented.
Three Months Ended September 30,Nine Months Ended September 30,
2023202220232022
(In millions)
Total revenue:
Medicaid$6,976 $6,380 $20,282 $19,091 
Medicare1,046 955 3,157 2,867 
Marketplace507 575 1,528 1,740 
Other19 17 57 53 
Total$8,548 $7,927 $25,024 $23,751 
The following table reconciles margin by segment to consolidated income before income taxes.
Three Months Ended September 30,Nine Months Ended September 30,
2023202220232022
(In millions)
Margin:
Medicaid$752 $703 $2,242 $2,168 
Medicare78 108 317 360 
Marketplace104 77 393 255 
Other 2 2 7 8 
Total margin 936 890 2,959 2,791 
Add: other operating revenues (1)
289 274 800 732 
Less: other operating expenses (2)
(866)(829)(2,502)(2,455)
Operating income359 335 1,257 1,068 
Other expenses, net27 28 82 83 
Income before income tax expense$332 $307 $1,175 $985 
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(1)Other operating revenues include premium tax revenue, investment income, and certain other revenue.
(2)Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and certain other operating expenses, including a credit loss charge of $41 million as described in Note 2.