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Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($)
$ in Millions
 3 Months Ended 9 Months Ended
Sep. 30, 2024
Sep. 30, 2023
Sep. 30, 2024
Sep. 30, 2023
Segment Reporting Information [Line Items]        
Less: other operating expenses $ (9,873) $ (8,189) $ (28,824) $ (23,767)
Operating income 467 359 1,327 1,257
Less: interest expense 29 27 84 82
Income before income tax expense 438 332 1,243 1,175
Operating segments        
Segment Reporting Information [Line Items]        
Total margin 1,052 936 3,224 2,959
Operating segments | Medicaid        
Segment Reporting Information [Line Items]        
Total margin 730 752 2,188 2,242
Operating segments | Medicare        
Segment Reporting Information [Line Items]        
Total margin 142 78 522 317
Operating segments | Marketplace        
Segment Reporting Information [Line Items]        
Total margin 179 104 509 393
Operating segments | Other        
Segment Reporting Information [Line Items]        
Total margin 1 2 5 7
Other operating        
Segment Reporting Information [Line Items]        
Add: other operating revenues 626 289 1,447 800
Less: other operating expenses $ (1,211) $ (866) $ (3,344) $ (2,502)