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CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
 12 Months Ended
Dec. 31, 2024
Dec. 31, 2023
Dec. 31, 2022
Operating activities:      
Net income $ 1,179 $ 1,091 $ 792
Adjustments to reconcile net income to net cash provided by operating activities:      
Depreciation and amortization 186 171 176
Deferred income taxes 53 (31) (66)
Share-based compensation 116 115 103
Impairment 0 0 208
Other, net 8 2 8
Changes in operating assets and liabilities, net of the effect of acquisitions:      
Receivables (78) (778) (95)
Prepaid expenses and other current assets (57) (69) (124)
Medical claims and benefits payable (40) 580 153
Amounts due government agencies (453) 196 (428)
Accounts payable, accrued liabilities and other 115 328 55
Deferred revenue (367) 59 (11)
Income taxes (18) (2) 2
Net cash provided by operating activities 644 1,662 773
Investing activities:      
Purchases of investments (1,132) (1,433) (1,913)
Proceeds from sales and maturities of investments 1,111 772 1,398
Net cash paid in business combinations (344) (3) (134)
Purchases of property, equipment and capitalized software (100) (84) (91)
Other, net 1 4 (50)
Net cash used in investing activities (464) (744) (790)
Financing activities:      
Common stock purchases (1,000) 0 (400)
Proceeds from senior notes offerings, net of issuance costs 740 0 0
Proceeds from borrowings under credit facility 300 0 0
Repayment of credit facility (300) 0 0
Common stock withheld to settle employee tax obligations (57) (60) (54)
Contingent consideration liabilities settled 0 0 (20)
Other, net (30) 2 33
Net cash used in financing activities (347) (58) (441)
Net (decrease) increase in cash and cash equivalents, and restricted cash and cash equivalents (167) 860 (458)
Cash and cash equivalents, and restricted cash and cash equivalents at beginning of period 4,908 4,048 4,506
Cash and cash equivalents, and restricted cash and cash equivalents at end of period 4,741 4,908 4,048
Cash paid during the period for:      
Income taxes, net 379 405 340
Interest $ 121 $ 108 $ 108