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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Segment Reporting Information [Line Items]    
Less: other operating expenses $ (9,505) $ (7,694)
Operating income 426 455
Less: interest expense 27 28
Income before income tax expense 399 427
Operating segments    
Segment Reporting Information [Line Items]    
Total margin 1,092 1,016
Operating segments | Medicaid    
Segment Reporting Information [Line Items]    
Total margin 775 734
Operating segments | Medicare    
Segment Reporting Information [Line Items]    
Total margin 163 126
Operating segments | Marketplace    
Segment Reporting Information [Line Items]    
Total margin 152 154
Operating segments | Other    
Segment Reporting Information [Line Items]    
Total margin 2 2
Other operating    
Segment Reporting Information [Line Items]    
Add: other operating revenues 407 246
Less: other operating expenses $ (1,073) $ (807)