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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended 6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Jun. 30, 2024
Jun. 30, 2023
Segment Reporting Information [Line Items]        
Less: other operating expenses $ (9,446) $ (7,884) $ (18,951) $ (15,578)
Operating income 434 443 860 898
Less: interest expense 28 27 55 55
Income before income tax expense 406 416 805 843
Operating segments        
Segment Reporting Information [Line Items]        
Total margin 1,080 1,007 2,172 2,023
Operating segments | Medicaid        
Segment Reporting Information [Line Items]        
Total margin 683 756 1,458 1,490
Operating segments | Medicare        
Segment Reporting Information [Line Items]        
Total margin 217 113 380 239
Operating segments | Marketplace        
Segment Reporting Information [Line Items]        
Total margin 178 135 330 289
Operating segments | Other        
Segment Reporting Information [Line Items]        
Total margin 2 3 4 5
Other operating        
Segment Reporting Information [Line Items]        
Add: other operating revenues 414 265 821 511
Less: other operating expenses $ (1,060) $ (829) $ (2,133) $ (1,636)