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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2023	Sep. 30, 2022	Sep. 30, 2023	Sep. 30, 2022
Segment Reporting Information [Line Items]
Less: other operating expenses	$ (8,189.0)	$ (7,592.0)	$ (23,767.0)	$ (22,683.0)
Operating income	359.0	335.0	1,257.0	1,068.0
Other expenses, net	27.0	28.0	82.0	83.0
Income before income tax expense	332.0	307.0	1,175.0	985.0
Risk adjustment, credit loss allowances	41.0		41.0
Operating segments
Segment Reporting Information [Line Items]
Total margin	936.0	890.0	2,959.0	2,791.0
Operating segments | Medicaid
Segment Reporting Information [Line Items]
Total margin	752.0	703.0	2,242.0	2,168.0
Operating segments | Medicare
Segment Reporting Information [Line Items]
Total margin	78.0	108.0	317.0	360.0
Operating segments | Marketplace
Segment Reporting Information [Line Items]
Total margin	104.0	77.0	393.0	255.0
Operating segments | Other
Segment Reporting Information [Line Items]
Total margin	2.0	2.0	7.0	8.0
Other operating
Segment Reporting Information [Line Items]
Add: other operating revenues	289.0	274.0	800.0	732.0
Less: other operating expenses	$ (866.0)	$ (829.0)	$ (2,502.0)	$ (2,455.0)

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