Centene (CNC) 10-Q 27 Jul 23 2023 Q2 Quarterly report Financial data

Cover

Cover - shares	6 Months Ended
	Jun. 30, 2023	Jul. 26, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2023
Document Transition Report	false
Entity File Number	001-31826
Entity Registrant Name	CENTENE CORPORATION
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	42-1406317
Entity Address, Address Line One	7700 Forsyth Boulevard
Entity Address, City or Town	St. Louis,
Entity Address, State or Province	MO
Entity Address, Postal Zip Code	63105
City Area Code	314
Local Phone Number	725-4477
Title of 12(b) Security	Common Stock $0.001 Par Value
Trading Symbol	CNC
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		541,479,163
Entity Central Index Key	0001071739
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q2
Amendment Flag	false

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 17,170	$ 12,074
Premium and trade receivables	13,601	13,272
Short-term investments	2,212	2,321
Other current assets	1,883	2,461
Total current assets	34,866	30,128
Long-term investments	16,108	14,684
Restricted deposits	1,355	1,217
Property, software and equipment, net	2,416	2,432
Goodwill	18,716	18,812
Intangible assets, net	6,520	6,911
Other long-term assets	2,872	2,686
Total assets	82,853	76,870
Current liabilities:
Medical claims liability	16,884	16,745
Accounts payable and accrued expenses	9,868	9,525
Return of premium payable	2,071	1,634
Unearned revenue	2,373	478
Current portion of long-term debt	110	82
Total current liabilities	31,306	28,464
Long-term debt	17,896	17,938
Deferred tax liability	495	615
Other long-term liabilities	7,369	5,616
Total liabilities	57,066	52,633
Commitments and contingencies
Redeemable noncontrolling interests	19	56
Stockholders' equity:
Preferred stock, $0.001 par value; authorized 10,000 shares; no shares issued or outstanding at June 30, 2023 and December 31, 2022	0	0
Common stock, $0.001 par value; authorized 800,000 shares; 614,743 issued and 546,003 outstanding at June 30, 2023, and 607,847 issued and 550,754 outstanding at December 31, 2022	1	1
Additional paid-in capital	20,183	20,060
Accumulated other comprehensive (loss)	(998)	(1,132)
Retained earnings	11,529	9,341
Treasury stock, at cost (68,740 and 57,093 shares, respectively)	(5,044)	(4,213)
Total Centene stockholders' equity	25,671	24,057
Nonredeemable noncontrolling interest	97	124
Total stockholders' equity	25,768	24,181
Total liabilities, redeemable noncontrolling interests and stockholders' equity	$ 82,853	$ 76,870

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Jun. 30, 2023	Dec. 31, 2022
Stockholders' equity
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	10,000,000	10,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	800,000,000	800,000,000
Common stock, shares issued (in shares)	614,743,000	607,847,000
Common stock, shares outstanding (in shares)	546,003,000	550,754,000
Treasury stock (in shares)	68,740,000	57,093,000

CONSOLIDATED STATEMENTS OF OPER

CONSOLIDATED STATEMENTS OF OPERATIONS - USD ($) shares in Thousands, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Revenues:
Premium and service revenues	$ 34,838	$ 33,968	$ 69,790	$ 68,200
Premium tax	2,770	1,968	6,707	4,921
Total revenues	37,608	35,936	76,497	73,121
Expenses:
Medical costs	29,347	27,312	58,781	55,150
Cost of services	877	2,099	1,747	4,087
Selling, general and administrative expenses	3,016	2,800	6,027	5,545
Depreciation expense	146	164	288	320
Amortization of acquired intangible assets	179	199	362	398
Premium tax expense	2,854	2,041	6,865	5,047
Impairment	18	1,450	38	1,450
Total operating expenses	36,437	36,065	74,108	71,997
Earnings (loss) from operations	1,171	(129)	2,389	1,124
Other income (expense):
Investment and other income	425	42	778	94
Debt extinguishment	0	13	0	16
Interest expense	(181)	(162)	(361)	(322)
Earnings (loss) before income tax	1,415	(236)	2,806	912
Income tax expense (benefit)	360	(65)	621	231
Net earnings (loss)	1,055	(171)	2,185	681
(Earnings) loss attributable to noncontrolling interests	3	(1)	3	(4)
Net earnings (loss) attributable to Centene Corporation	$ 1,058	$ (172)	$ 2,188	$ 677
Net earnings (loss) per common share attributable to Centene Corporation:
Basic earnings (loss) per common share (in dollars per share)	$ 1.93	$ (0.29)	$ 3.98	$ 1.16
Diluted earnings (loss) per common share (in dollars per share)	$ 1.92	$ (0.29)	$ 3.96	$ 1.15
Weighted average number of common shares outstanding:
Basic (in shares)	548,932	583,644	549,850	583,435
Diluted (in shares)	550,308	583,644	551,996	590,226
Premium
Revenues:
Premium and service revenues	$ 33,713	$ 31,510	$ 67,538	$ 63,399
Service
Revenues:
Premium and service revenues	$ 1,125	$ 2,458	$ 2,252	$ 4,801

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE EARNINGS (LOSS) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Statement of Comprehensive Income [Abstract]
Net earnings (loss)	$ 1,055	$ (171)	$ 2,185	$ 681
Change in unrealized gain (loss) on investments	(142)	(446)	111	(1,161)
Change in unrealized gain (loss) on investments, tax effect	34	106	(27)	277
Change in unrealized gain (loss) on investments, net of tax	(108)	(340)	84	(884)
Reclassification adjustment, net of tax	2	7	4	9
Foreign currency translation adjustments, net of tax	23	(95)	46	(115)
Other comprehensive earnings (loss)	(83)	(428)	134	(990)
Comprehensive earnings (loss)	972	(599)	2,319	(309)
Comprehensive (earnings) loss attributable to noncontrolling interests	3	(1)	3	(4)
Comprehensive earnings (loss) attributable to Centene Corporation	$ 975	$ (600)	$ 2,322	$ (313)

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Thousands, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Earnings (Loss)	Retained Earnings	Treasury Stock	Noncontrolling Interest
Balance (in shares) at Dec. 31, 2021		602,704
Treasury stock (in shares) at Dec. 31, 2021						20,225
Balance at Dec. 31, 2021	$ 26,940	$ 1	$ 19,672	$ 77	$ 8,139	$ (1,094)	$ 145
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	848				849		(1)
Other comprehensive earnings (loss), net of tax	(562)			(562)
Common stock issued for employee benefit plans (in shares)		3,221
Common stock issued for employee benefit plans	28		28
Fair value of unvested equity awards in connection with acquisition	60		60
Common stock repurchases (in shares)						846
Common stock repurchases	(71)					$ (71)
Stock compensation expense	70		70
Balance (in shares) at Mar. 31, 2022		605,925
Treasury stock (in shares) at Mar. 31, 2022						21,071
Balance at Mar. 31, 2022	27,313	$ 1	19,830	(485)	8,988	$ (1,165)	144
Balance (in shares) at Dec. 31, 2021		602,704
Treasury stock (in shares) at Dec. 31, 2021						20,225
Balance at Dec. 31, 2021	26,940	$ 1	19,672	77	8,139	$ (1,094)	145
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Other comprehensive earnings (loss), net of tax	(990)
Balance (in shares) at Jun. 30, 2022		606,444
Treasury stock (in shares) at Jun. 30, 2022						25,320
Balance at Jun. 30, 2022	26,430	$ 1	19,899	(913)	8,816	$ (1,514)	141
Balance (in shares) at Mar. 31, 2022		605,925
Treasury stock (in shares) at Mar. 31, 2022						21,071
Balance at Mar. 31, 2022	27,313	$ 1	19,830	(485)	8,988	$ (1,165)	144
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	(175)				(172)		(3)
Other comprehensive earnings (loss), net of tax	(428)			(428)
Common stock issued for employee benefit plans (in shares)		519
Common stock issued for employee benefit plans	10		10
Common stock repurchases (in shares)						4,249
Common stock repurchases	(349)					$ (349)
Stock compensation expense	59		59
Balance (in shares) at Jun. 30, 2022		606,444
Treasury stock (in shares) at Jun. 30, 2022						25,320
Balance at Jun. 30, 2022	$ 26,430	$ 1	19,899	(913)	8,816	$ (1,514)	141
Balance (in shares) at Dec. 31, 2022	550,754	607,847
Treasury stock (in shares) at Dec. 31, 2022	57,093					57,093
Balance at Dec. 31, 2022	$ 24,181	$ 1	20,060	(1,132)	9,341	$ (4,213)	124
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	1,130				1,130
Other comprehensive earnings (loss), net of tax	217			217
Common stock issued for employee benefit plans (in shares)		6,508
Common stock issued for employee benefit plans	12		12
Common stock repurchases (in shares)						5,548
Common stock repurchases	(423)					$ (423)
Stock compensation expense	61		61
Purchase of redeemable and non-redeemable noncontrolling interest	(12)		(12)
Balance (in shares) at Mar. 31, 2023		614,355
Treasury stock (in shares) at Mar. 31, 2023						62,641
Balance at Mar. 31, 2023	$ 25,166	$ 1	20,121	(915)	10,471	$ (4,636)	124
Balance (in shares) at Dec. 31, 2022	550,754	607,847
Treasury stock (in shares) at Dec. 31, 2022	57,093					57,093
Balance at Dec. 31, 2022	$ 24,181	$ 1	20,060	(1,132)	9,341	$ (4,213)	124
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Other comprehensive earnings (loss), net of tax	$ 134
Balance (in shares) at Jun. 30, 2023	546,003	614,743
Treasury stock (in shares) at Jun. 30, 2023	68,740					68,740
Balance at Jun. 30, 2023	$ 25,768	$ 1	20,183	(998)	11,529	$ (5,044)	97
Balance (in shares) at Mar. 31, 2023		614,355
Treasury stock (in shares) at Mar. 31, 2023						62,641
Balance at Mar. 31, 2023	25,166	$ 1	20,121	(915)	10,471	$ (4,636)	124
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net earnings (loss)	1,055				1,058		(3)
Other comprehensive earnings (loss), net of tax	(83)			(83)
Common stock issued for employee benefit plans (in shares)		388
Common stock issued for employee benefit plans	9		9
Common stock repurchases (in shares)						6,099
Common stock repurchases	(408)					$ (408)
Stock compensation expense	56		56
Purchase of redeemable and non-redeemable noncontrolling interest	$ (27)		(3)				(24)
Balance (in shares) at Jun. 30, 2023	546,003	614,743
Treasury stock (in shares) at Jun. 30, 2023	68,740					68,740
Balance at Jun. 30, 2023	$ 25,768	$ 1	$ 20,183	$ (998)	$ 11,529	$ (5,044)	$ 97

CONSOLIDATED STATEMENTS OF ST_2

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY (Parenthetical) - USD ($) $ in Millions	3 Months Ended				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022	Dec. 31, 2021
Par value (in dollars per share)	$ 0.001				$ 0.001		$ 0.001
Other comprehensive earning (loss), tax	$ (34)	$ 61	$ (106)	$ (171)	$ 27	$ (277)
Common Stock
Par value (in dollars per share)	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	0.001	$ 0.001
Treasury Stock
Par value (in dollars per share)	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001	$ 0.001

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Cash flows from operating activities:
Net earnings	$ 1,055	$ (171)	$ 2,185	$ 681
Adjustments to reconcile net earnings to net cash provided by operating activities
Depreciation and amortization			650	718
Stock compensation expense			117	129
Impairment	18	1,450	38	1,450
(Gain) loss on debt extinguishment			0	(16)
(Gain) on acquisition			0	(2)
Deferred income taxes			(160)	(417)
(Gain) on divestiture			(172)	0
Other adjustments, net			68	162
Changes in assets and liabilities
Premium and trade receivables			(319)	(1,288)
Other assets			(325)	(245)
Medical claims liabilities			139	2,089
Unearned revenue			1,895	75
Accounts payable and accrued expenses			618	41
Other long-term liabilities			2,081	1,058
Other operating activities, net			0	70
Net cash provided by operating activities			6,815	4,505
Cash flows from investing activities:
Capital expenditures			(440)	(524)
Purchases of investments			(3,199)	(3,114)
Sales and maturities of investments			2,293	2,005
Acquisitions, net of cash acquired			0	(1,512)
Divestiture proceeds, net of divested cash			669	0
Net cash (used in) investing activities			(677)	(3,145)
Cash flows from financing activities:
Proceeds from long-term debt			1,281	331
Payments and repurchases of long-term debt			(1,322)	(900)
Common stock repurchases			(828)	(420)
Proceeds from common stock issuances			21	38
Payments for debt extinguishment			0	(27)
Purchase of noncontrolling interest			(85)	0
Other financing activities, net			0	(6)
Net cash (used in) financing activities			(933)	(984)
Effect of exchange rate changes on cash, cash equivalents, and restricted cash			(7)	(9)
Net increase in cash, cash equivalents, and restricted cash and cash equivalents			5,198	367
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period			12,330	13,214	$ 13,214
Cash, cash equivalents, and restricted cash and cash equivalents, end of period	17,528	13,581	17,528	13,581	12,330
Supplemental disclosures of cash flow information:
Interest paid			348	327
Income taxes paid			592	411
The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the Consolidated Balance Sheets to the totals above:
Cash and cash equivalents	17,170	13,435	17,170	13,435	12,074
Restricted cash and cash equivalents, included in restricted deposits	358	146	358	146
Total cash, cash equivalents, and restricted cash and cash equivalents	$ 17,528	$ 13,581	$ 17,528	$ 13,581	$ 12,330

Organization and Operations

Organization and Operations	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Operations	Organization and Operations Basis of Presentation The accompanying interim financial statements have been prepared under the presumption that users of the interim financial information have either read or have access to the audited financial statements included in the Form 10-K for the fiscal year ended December 31, 2022. The unaudited interim financial statements herein have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission. Accordingly, footnote disclosures that would substantially duplicate the disclosures contained in the December 31, 2022 audited financial statements have been omitted from these interim financial statements, where appropriate. In the opinion of management, these financial statements reflect all adjustments, consisting only of normal recurring adjustments, which are necessary for a fair presentation of the results of the interim periods presented. Certain 2022 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2023 presentation, including reclassifications related to the Company's new segment reporting structure as outlined below. These reclassifications have no effect on net earnings or stockholders' equity as previously reported. Segment Reporting In the first quarter of 2023, and in conjunction with the Company's updated strategic plan, executive leadership realignment, and corresponding 2023 divestitures, the Company revised the way it manages the business, evaluates performance, and allocates resources, resulting in an updated segment structure comprised of (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment, and (4) an Other segment. The Medicaid, Medicare, and Commercial segments represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. Specifically, the Medicaid segment includes the Temporary Assistance for Needy Families (TANF) program, Medicaid Expansion programs, the Aged, Blind, or Disabled (ABD) program, the Children's Health Insurance Program (CHIP), Long-Term Services and Supports (LTSS), Foster Care, Medicare-Medicaid Plans (MMP), which cover beneficiaries who are dually eligible for Medicaid and Medicare, and other state-based programs. The Medicare segment includes Medicare Advantage, Medicare Supplement, Dual Eligible Special Needs Plans (D-SNPs), and Medicare Prescription Drug Plans (PDPs), also known as Medicare Part D. The Commercial segment includes the Health Insurance Marketplace along with individual, small group, and large group commercial healthcare products. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others. Accounting Guidance Not Yet Adopted The Company has determined that there are no recently issued accounting pronouncements that will have a material impact on its consolidated financial position, results of operations, or cash flows.

Acquisitions and Divestitures

Acquisitions and Divestitures	6 Months Ended
	Jun. 30, 2023
Business Combination and Asset Acquisition [Abstract]
Acquisitions and Divestitures	Acquisitions and Divestitures On January 5, 2023, the Company completed the divestiture of HealthSmart, its third-party health plan administration business. On January 10, 2023, the Company signed and closed on a definitive agreement to divest Centurion, its prison healthcare business. During 2022, the Company recorded impairment charges related to goodwill and other current assets associated with the pending divestiture. During the second quarter of 2023, the Company recognized a $15 million gain on the divestiture of the Centurion business reflecting additional proceeds for contingent consideration, partially offset by net working capital adjustments. The gain is included in investment and other income on the Consolidated Statements of Operations. On January 20, 2023, the Company completed the divestiture of Magellan Specialty Health for approximately $646 million in cash and stock, including an estimated working capital adjustment and recognized a pre-tax gain of $79 million. The stock consideration was subsequently sold in April 2023 for cash proceeds of $245 million. The Company could also receive up to an additional $150 million in cash and stock in 2024 based on certain 2023 performance metrics. The Company will recognize the appropriate amount of contingent consideration related to the additional $150 million when realized or realizable. On June 13, 2023, the Company completed the divestiture of its majority stake in Apixio. The Company recognized a pre-tax gain of $91 million, or $63 million after-tax, which is included in investment and other income on the Consolidated Statements of Operations. During the second quarter of 2023, the Company recognized an additional $13 million expense related to the divestiture of its Spanish and Central European businesses, in addition to the previously recorded impairment charge of $163 million, or $140 million after-tax. The expense is included in investment and other income on the Consolidated Statements of Operations.

Short-term and Long-term Invest

Short-term and Long-term Investments, Restricted Deposits	6 Months Ended
	Jun. 30, 2023
Investments, Debt and Equity Securities [Abstract]
Short-term and Long-term Investments, Restricted Deposits	Short-term and Long-term Investments, Restricted Deposits Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): June 30, 2023 December 31, 2022 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 465 $ — $ (15) $ 450 $ 695 $ — $ (16) $ 679 Corporate securities 10,578 13 (724) 9,867 10,127 12 (778) 9,361 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 358 — — 358 256 — — 256 Short-term time deposits 419 — — 419 204 — — 204 Municipal securities 4,156 9 (234) 3,931 4,055 6 (280) 3,781 Asset-backed securities 1,507 1 (60) 1,448 1,396 — (70) 1,326 Residential mortgage-backed securities 1,346 1 (120) 1,227 1,165 2 (121) 1,046 Commercial mortgage-backed securities 1,081 — (100) 981 961 — (99) 862 Equity securities 2 — — 2 5 — — 5 Private equity investments 805 — — 805 529 — — 529 Life insurance contracts 183 — — 183 169 — — 169 Total $ 20,904 $ 24 $ (1,253) $ 19,675 $ 19,566 $ 20 $ (1,364) $ 18,222 The Company's investments are debt securities classified as available-for-sale with the exception of equity securities, certain private equity investments, and life insurance contracts. The Company's investment policies are designed to provide liquidity, preserve capital, and maximize total return on invested assets with a focus on high credit quality securities. The Company limits the size of investment in any single issuer other than U.S. treasury securities and obligations of U.S. government corporations and agencies. As of June 30, 2023, 99% of the Company's investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations. At June 30, 2023, the Company held certificates of deposit, equity securities, private equity investments, and life insurance contracts, which did not carry a credit rating. Accrued interest income on available-for-sale debt securities was $149 million and $132 million at June 30, 2023 and December 31, 2022, respectively, and is included in other current assets on the Consolidated Balance Sheets. The Company's residential mortgage-backed securities are primarily issued by the Federal National Mortgage Association, Government National Mortgage Association, or Federal Home Loan Mortgage Corporation, which carry implicit or explicit guarantees of the U.S. government. The Company's commercial mortgage-backed securities are primarily senior tranches with a weighted average rating of AAA and a weighted average duration of 4 years at June 30, 2023. The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): June 30, 2023 December 31, 2022 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ (3) $ 207 $ (12) $ 191 $ (5) $ 342 $ (11) $ 184 Corporate securities (73) 2,942 (651) 6,049 (340) 5,368 (438) 3,400 Municipal securities (26) 1,413 (208) 1,990 (142) 2,437 (138) 995 Asset-backed securities (8) 431 (52) 949 (29) 786 (41) 486 Residential mortgage-backed securities (16) 494 (104) 644 (55) 629 (66) 352 Commercial mortgage-backed securities (8) 224 (92) 736 (49) 513 (50) 330 Total $ (134) $ 5,711 $ (1,119) $ 10,559 $ (620) $ 10,075 $ (744) $ 5,747 As of June 30, 2023, the gross unrealized losses were generated from 6,392 positions out of a total of 6,910 positions. The change in fair value of available-for-sale debt securities is primarily a result of movement in interest rates subsequent to the purchase of the security. For each security in an unrealized loss position, the Company assesses whether it intends to sell the security or if it is more likely than not the Company will be required to sell the security before recovery of the amortized cost basis for reasons such as liquidity, contractual, or regulatory purposes. If the security meets this criterion, the decline in fair value is recorded in earnings. The Company does not intend to sell these securities prior to maturity and it is not likely that the Company will be required to sell these securities prior to maturity; therefore, the Company did not record an impairment for these securities. In addition, the Company monitors available-for-sale debt securities for credit losses. Certain investments have experienced a decline in fair value due to changes in credit quality, market interest rates, and/or general economic conditions. The Company recognizes an allowance when evidence demonstrates that the decline in fair value is credit related. Evidence of a credit related loss may include rating agency actions, adverse conditions specifically related to the security, or failure of the issuer of the security to make scheduled payments. The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): June 30, 2023 December 31, 2022 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 2,095 $ 2,064 $ 627 $ 625 $ 2,207 $ 2,179 $ 534 $ 532 One year through five years 8,144 7,630 509 477 7,651 7,147 524 490 Five years through ten years 4,169 3,826 254 232 4,066 3,613 224 195 Greater than ten years 160 154 22 21 135 129 — — Asset-backed securities 3,934 3,656 — — 3,522 3,234 — — Total $ 18,502 $ 17,330 $ 1,412 $ 1,355 $ 17,581 $ 16,302 $ 1,282 $ 1,217 Actual maturities may differ from contractual maturities due to call or prepayment options. Equity securities, private equity investments, and life insurance contracts are excluded from the table above because they do not have a contractual maturity. The Company has an option to redeem at amortized cost substantially all of the securities included in the greater than ten years category listed above.

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date. The following table summarizes fair value measurements by level at June 30, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,170 $ — $ — $ 17,170 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 112 $ — $ — $ 112 Corporate securities — 9,833 — 9,833 Municipal securities — 3,310 — 3,310 Short-term time deposits — 419 — 419 Asset-backed securities — 1,448 — 1,448 Residential mortgage-backed securities — 1,227 — 1,227 Commercial mortgage-backed securities — 981 — 981 Equity securities — 2 — 2 Total investments $ 112 $ 17,220 $ — $ 17,332 Restricted deposits: Cash and cash equivalents $ 358 $ — $ — $ 358 U.S. Treasury securities and obligations of U.S. government corporations and agencies 338 — — 338 Corporate securities — 34 — 34 Certificates of deposit — 4 — 4 Municipal securities — 621 — 621 Total restricted deposits $ 696 $ 659 $ — $ 1,355 Total assets at fair value $ 17,978 $ 17,879 $ — $ 35,857 The following table summarizes fair value measurements by level at December 31, 2022, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 12,074 $ — $ — $ 12,074 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 366 $ 5 $ — $ 371 Corporate securities — 9,328 — 9,328 Municipal securities — 3,165 — 3,165 Short-term time deposits — 204 — 204 Asset backed securities — 1,326 — 1,326 Residential mortgage-backed securities — 1,046 — 1,046 Commercial mortgage-backed securities — 862 — 862 Equity securities 3 2 — 5 Total investments $ 369 $ 15,938 $ — $ 16,307 Restricted deposits: Cash and cash equivalents $ 256 $ — $ — $ 256 U.S. Treasury securities and obligations of U.S. government corporations and agencies 308 — — 308 Corporate securities — 33 — 33 Certificates of deposit — 4 — 4 Municipal securities — 616 — 616 Total restricted deposits $ 564 $ 653 $ — $ 1,217 Total assets at fair value $ 13,007 $ 16,591 $ — $ 29,598 The Company utilizes matrix-pricing services to estimate fair value for securities which are not actively traded on the measurement date. The Company designates these securities as Level II fair value measurements. In addition, the aggregate carrying amount of the Company's private equity investments and life insurance contracts, which approximates fair value, was $988 million and $698 million as of June 30, 2023 and December 31, 2022, respectively.

Goodwill and Intangible Assets

Goodwill and Intangible Assets	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill and Intangible Assets	Goodwill and Intangible Assets As discussed in Note 1. Organization and Operations, in the first quarter of 2023 the Company updated its segment structure. Prior year information has been adjusted to reflect the change in segment reporting. The following table summarizes the changes in goodwill by operating segment ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, December 31, 2021 $ 10,194 $ 1,592 $ 5,424 $ 2,561 $ 19,771 Acquisition and purchase accounting adjustments — — — 1,077 1,077 Divestitures — — — (1,533) (1,533) Reallocation 4 — — (4) — Impairments — — — (370) (370) Translation impact — — — (133) (133) Balance, December 31, 2022 $ 10,198 $ 1,592 $ 5,424 $ 1,598 $ 18,812 Divestitures — — — (152) (152) Translation impact — — — 56 56 Balance, June 30, 2023 $ 10,198 $ 1,592 $ 5,424 $ 1,502 $ 18,716

Medical Claims Liability

Medical Claims Liability	6 Months Ended
	Jun. 30, 2023
Insurance [Abstract]
Medical Claims Liability	Medical Claims Liability As discussed in Note 1. Organization and Operations, in the first quarter of 2023 the Company updated its segment structure. Prior year information has been adjusted to reflect the change in segment reporting. The following table summarizes the change in medical claims liability for the six months ended June 30, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverable 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 40,622 10,083 8,857 773 60,335 Prior years (1,153) (191) (208) (2) (1,554) Total incurred 39,469 9,892 8,649 771 58,781 Paid related to: Current year 31,837 7,726 6,751 656 46,970 Prior years 7,890 2,357 1,282 137 11,666 Total paid 39,727 10,083 8,033 793 58,636 Balance, June 30, 2023, net 10,988 3,240 2,518 118 16,864 Plus: Reinsurance recoverable 5 — 15 — 20 Balance, June 30, 2023 $ 10,993 $ 3,240 $ 2,533 $ 118 $ 16,884 The following table summarizes the change in medical claims liability for the six months ended June 30, 2022 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2022 $ 9,845 $ 2,286 $ 2,014 $ 98 $ 14,243 Less: Reinsurance recoverable 23 — — — 23 Balance, January 1, 2022, net 9,822 2,286 2,014 98 14,220 Acquisitions and divestitures — — — 249 249 Incurred related to: Current year 37,803 9,918 7,001 1,457 56,179 Prior years (770) (46) (198) (15) (1,029) Total incurred 37,033 9,872 6,803 1,442 55,150 Paid related to: Current year 29,007 6,977 5,475 1,427 42,886 Prior years 6,808 1,784 1,489 80 10,161 Total paid 35,815 8,761 6,964 1,507 53,047 Balance, June 30, 2022, net 11,040 3,397 1,853 282 16,572 Plus: Reinsurance recoverable 9 — — — 9 Balance, June 30, 2022 $ 11,049 $ 3,397 $ 1,853 $ 282 $ 16,581 Reinsurance recoverables related to medical claims are included in premium and trade receivables. Changes in estimates of incurred claims for prior years are primarily attributable to reserving under moderately adverse conditions. Additionally, as a result of minimum health benefits ratio (HBR) and other return of premium programs, the Company recorded $319 million and $48 million as a reduction to premium revenue in the six months ended June 30, 2023 and 2022, respectively.

Affordable Care Act

Affordable Care Act	6 Months Ended
	Jun. 30, 2023
Affordable Care Act [Abstract]
Affordable Care Act	Affordable Care Act The Affordable Care Act established risk spreading premium stabilization programs as well as a minimum annual medical loss ratio (MLR) and cost sharing reductions. The Company's net receivables (payables) for each of the programs are as follows ($ in millions): June 30, 2023 December 31, 2022 Risk adjustment receivable $ 1,088 $ 838 Risk adjustment payable (2,303) (780) Minimum medical loss ratio (233) (103) Cost sharing reduction receivable 2 — Cost sharing reduction payable (87) (99) In June 2023, the Centers for Medicare and Medicaid Services (CMS) announced the final risk adjustment transfers for the 2022 benefit year. As a result of the announcement, the Company increased its risk adjustment net receivables by $240 million from December 31, 2022. After consideration of minimum MLR and other related impacts, the net pre-tax benefit recognized was approximately $196 million in the six months ended June 30, 2023.

Debt

Debt	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Debt	Debt Debt consists of the following ($ in millions): June 30, 2023 December 31, 2022 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,394 $ 2,393 $2,300 million 2.45% Senior Notes due July 15, 2028 2,303 2,303 $3,500 million 4.625% Senior Notes due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes due August 1, 2031 1,300 1,300 Total senior notes 15,674 15,673 Term loan facility 2,156 2,183 Revolving credit agreement 61 58 Finance leases and other 250 253 Debt issuance costs (135) (147) Total debt 18,006 18,020 Less: current portion (110) (82) Long-term debt $ 17,896 $ 17,938

Leases

Leases	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
Leases	Leases The following table sets forth the right-of-use (ROU) assets and lease liabilities ($ in millions): June 30, 2023 December 31, 2022 Assets ROU assets (recorded within other long-term assets) $ 2,613 $ 2,554 Liabilities Short-term (recorded within accounts payable and accrued expenses) $ 176 $ 180 Long-term (recorded within other long-term liabilities) 3,171 3,133 Total lease liabilities $ 3,347 $ 3,313 As of June 30, 2023, the weighted average remaining lease term for the Company was 21.0 years. The average remaining lease term of the Circle Health portfolio is 27.3 years. Excluding Circle Health, the Company's portfolio average remaining lease term is 8.4 years. The lease liabilities as of June 30, 2023 reflect a weighted average discount rate of 5.9%.

Stockholders' Equity

Stockholders' Equity	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity The Company's Board of Directors has authorized a stock repurchase program of the Company's common stock from time to time on the open market or through privately negotiated transactions. In 2022, the Company's Board of Directors authorized increases under the program including $3,000 million in June 2022 and an additional $2,000 million in December 2022. With these increases, the Company is authorized to repurchase up to $6,000 million, inclusive of past authorizations. As of June 30, 2023, the Company had a remaining amount of $2,029 million available under the stock repurchase program. In July 2023, the Company repurchased an additional 4.5 million shares for $300 million. The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Shares Cost Shares Cost Shares Cost Shares Cost Share buybacks 6,028 $ 400 4,188 $ 344 10,880 $ 777 4,188 $ 344 Income tax withholding 71 5 61 5 767 51 907 76 Total share repurchases (1) 6,099 $ 405 4,249 $ 349 11,647 $ 828 5,095 $ 420 (1) Excludes share repurchase excise tax of $3 million accrued as of June 30, 2023. Shares repurchased for income tax withholding are shares withheld in connection with employee stock plans to meet applicable tax withholding requirements. These shares are typically included in the Company's treasury stock.

Earnings Per Share

Earnings Per Share	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Earnings Per Share	Earnings Per Share The following table sets forth the calculation of basic and diluted net earnings (loss) per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Earnings (loss) attributable to Centene Corporation $ 1,058 $ (172) $ 2,188 $ 677 Shares used in computing per share amounts: Weighted average number of common shares outstanding 548,932 583,644 549,850 583,435 Common stock equivalents (as determined by applying the treasury stock method) (1) 1,376 — 2,146 6,791 Weighted average number of common shares and potential dilutive common shares outstanding 550,308 583,644 551,996 590,226 Net earnings (loss) per common share attributable to Centene Corporation: Basic earnings (loss) per common share $ 1.93 $ (0.29) $ 3.98 $ 1.16 Diluted earnings (loss) per common share $ 1.92 $ (0.29) $ 3.96 $ 1.15 (1) The reduction in common stock equivalents is primarily driven by the distribution of long-term stock awards to the estate of the Company's former CEO during the first quarter of 2023, which were fully dilutive prior to their distribution. The calculation of diluted earnings per common share for the three months ended June 30, 2023 excludes 2 million shares related to anti-dilutive stock options, restricted stock, and restricted stock units. The calculation of diluted (loss) per common share for the three months ended June 30, 2022 excludes 6 million shares related to anti-dilutive stock equivalents due to the net loss for the quarter. The calculation of diluted earnings per common share for the six months ended June 30, 2023 and 2022 excludes 2 million shares and 226 thousand shares, respectively, related to anti-dilutive stock options, restricted stock, and restricted stock units.

Segment Information

Segment Information	6 Months Ended
	Jun. 30, 2023
Segment Reporting [Abstract]
Segment Information	Segment Information In the first quarter of 2023, and in conjunction with the Company's updated strategic plan, executive leadership realignment, and corresponding 2023 divestitures, the Company revised the way it manages the business, evaluates performance, and allocates resources, resulting in an updated segment structure comprised of (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment and (4) an Other segment. Prior year information has been adjusted to reflect the change in segment reporting. The Medicaid, Medicare, and Commercial segments represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others. Factors used in determining the reportable business segments include the nature of operating activities, the existence of separate senior management teams, and the type of information presented to the Company's chief operating decision-maker to evaluate all results of operations. The Company does not report total assets by segment since this is not a metric used to allocate resources or evaluate segment performance. Segment information for the three months ended June 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,895 $ 5,665 $ 5,734 $ 419 $ 33,713 Service — — — 1,125 1,125 Premium and service revenues 21,895 5,665 5,734 1,544 34,838 Premium tax 2,770 — — — 2,770 Total external revenues 24,665 5,665 5,734 1,544 37,608 Internal revenues — — — 3,789 3,789 Eliminations — — — (3,789) (3,789) Total revenues $ 24,665 $ 5,665 $ 5,734 $ 1,544 $ 37,608 Medical costs $ 19,459 $ 4,884 $ 4,644 $ 360 $ 29,347 Cost of services $ 2 $ — $ — $ 875 $ 877 Gross margin (1) $ 2,434 $ 781 $ 1,090 $ 309 $ 4,614 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended June 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 20,488 $ 5,639 $ 4,554 $ 829 $ 31,510 Service (1) — 1 2,458 2,458 Premium and service revenues 20,487 5,639 4,555 3,287 33,968 Premium tax 1,968 — — — 1,968 Total external revenues 22,455 5,639 4,555 3,287 35,936 Internal revenues — — — 5,986 5,986 Eliminations — — — (5,986) (5,986) Total revenues $ 22,455 $ 5,639 $ 4,555 $ 3,287 $ 35,936 Medical costs $ 18,258 $ 4,826 $ 3,529 $ 699 $ 27,312 Cost of services $ — $ — $ — $ 2,099 $ 2,099 Gross margin (1) $ 2,229 $ 813 $ 1,026 $ 489 $ 4,557 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the six months ended June 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 44,122 $ 11,541 $ 10,986 $ 889 $ 67,538 Service — — — 2,252 2,252 Premium and service revenues 44,122 11,541 10,986 3,141 69,790 Premium tax 6,707 — — — 6,707 Total external revenues 50,829 11,541 10,986 3,141 76,497 Internal revenues — — — 7,656 7,656 Eliminations — — — (7,656) (7,656) Total revenues $ 50,829 $ 11,541 $ 10,986 $ 3,141 $ 76,497 Medical costs $ 39,469 $ 9,892 $ 8,649 $ 771 $ 58,781 Cost of services $ 2 $ — $ — $ 1,745 $ 1,747 Gross margin (1) $ 4,651 $ 1,649 $ 2,337 $ 625 $ 9,262 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the six months ended June 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 41,609 $ 11,396 $ 8,686 $ 1,708 $ 63,399 Service (1) — 1 4,801 4,801 Premium and service revenues 41,608 11,396 8,687 6,509 68,200 Premium tax 4,921 — — — 4,921 Total external revenues 46,529 11,396 8,687 6,509 73,121 Internal revenues — — — 12,436 12,436 Eliminations — — — (12,436) (12,436) Total revenues $ 46,529 $ 11,396 $ 8,687 $ 6,509 $ 73,121 Medical costs $ 37,033 $ 9,872 $ 6,803 $ 1,442 $ 55,150 Cost of services $ — $ — $ — $ 4,087 $ 4,087 Gross margin (1) $ 4,575 $ 1,524 $ 1,884 $ 980 $ 8,963 (1) Gross margin represents premium and service revenues less medical costs and cost of services.

Contingencies

Contingencies	6 Months Ended
	Jun. 30, 2023
Commitments and Contingencies Disclosure [Abstract]
Contingencies	Contingencies Overview The Company is routinely subjected to legal and regulatory proceedings in the normal course of business. These matters can include, without limitation: • periodic compliance and other reviews and investigations by various federal and state regulatory agencies with respect to requirements applicable to the Company's business, including, without limitation, those related to payment of out-of-network claims, submissions to CMS related to risk adjustment payments, or the False Claims Act, the calculation of minimum MLR and rebates related thereto, submissions to state agencies related to payments or state false claims acts, pre-authorization penalties, timely review of grievances and appeals, timely and accurate payment of claims, cybersecurity issues, including those related to the Company's or the Company's third party vendors' information systems, and the Health Insurance Portability and Accountability Act of 1996 and other federal and state fraud, waste and abuse laws; • litigation arising out of general business activities, such as tax matters, disputes related to healthcare benefits coverage or reimbursement, putative securities class actions, and medical malpractice, privacy, real estate, intellectual property and employment-related claims; and • disputes regarding reinsurance arrangements, claims arising out of the acquisition or divestiture of various assets, class actions, and claims relating to the performance of contractual and non-contractual obligations to providers, members, employer groups and others, including, but not limited to, the alleged failure to properly pay claims and challenges to the manner in which the Company processes claims, claims related to network adequacy and claims alleging that the Company has engaged in unfair business practices. Among other things, these matters may result in awards of damages, fines or penalties, which could be substantial, and/or could require changes to the Company's business. The Company intends to vigorously defend itself against legal and regulatory proceedings to which it is currently a party; however, these proceedings are subject to many uncertainties. In some of the cases pending against the Company, substantial non-economic or punitive damages are being sought. The Company records reserves and accrues costs for certain legal proceedings and regulatory matters to the extent that it determines an unfavorable outcome is probable and the amount of the loss can be reasonably estimated. While such reserves and accrued costs reflect the Company's best estimate of the probable loss for such matters, the recorded amounts may differ materially from the actual amount of any such losses. In some cases, no estimate of the possible loss or range of loss in excess of amounts accrued, if any, can be made because of the inherently unpredictable nature of legal and regulatory proceedings, which may be exacerbated by various factors, including but not limited to, they may involve indeterminate claims for monetary damages or may involve fines, penalties or punitive damages; present novel legal theories or legal uncertainties; involve disputed facts; represent a shift in regulatory policy; involve a large number of parties, claimants or regulatory bodies; are in the early stages of the proceedings; involve a number of separate proceedings and/or a wide range of potential outcomes; or result in a change of business practices. As of the date of this report, amounts accrued for legal proceedings and regulatory matters were not material, except for the reserve estimate as described below with respect to claims or potential claims involving services provided by Envolve Pharmacy Solutions, Inc. (Envolve), as the Company's pharmacy benefits management (PBM) subsidiary. It is possible that in a particular quarter or annual period the Company's financial condition, results of operations, cash flow and/or liquidity could be materially adversely affected by an ultimate unfavorable resolution of or development in legal and/or regulatory proceedings, including as described below. Except for the discussion below, the Company believes that the ultimate outcome of any of the regulatory and legal proceedings that are currently pending against it should not have a material adverse effect on financial condition, results of operations, cash flow, or liquidity. California On October 20, 2015, the Company's California subsidiary, Health Net of California, Inc. (Health Net California), was named as a defendant in a California taxpayer action filed in Los Angeles County Superior Court, captioned as Michael D. Myers v. State Board of Equalization, Dave Jones, Insurance Commissioner of the State of California, Betty T. Yee, Controller of the State of California, et al., Los Angeles Superior Court Case No. BS158655. This action is brought under a California statute that permits an individual taxpayer to sue a governmental agency when the taxpayer believes the agency has failed to enforce governing law. Plaintiff contends that Health Net California, a California licensed Health Care Service Plan (HCSP), is an "insurer" for purposes of taxation despite acknowledging it is not an "insurer" under regulatory law. Under California law, "insurers" must pay a gross premiums tax (GPT), calculated as 2.35% on gross premiums. As a licensed HCSP, Health Net California has paid the California Corporate Franchise Tax (CFT), the tax generally paid by California businesses. Plaintiff contends that Health Net California must pay the GPT rather than the CFT. Plaintiff seeks a writ of mandate directing the California taxing agencies to collect the GPT, and seeks an order requiring Health Net California to pay GPT, interest and penalties for a period dating to eight years prior to the October 2015 filing of the complaint. This lawsuit is being coordinated with similar lawsuits filed against other entities (collectively, Related Actions). In March 2018, the Court overruled the Company's demurrer seeking to dismiss the complaint and denied the Company's motion to strike allegations seeking retroactive relief. In August 2018, the trial court stayed all the Related Actions pending determination of a writ of mandate by the California Court of Appeals in two of the Related Actions. In March 2019, the California Court of Appeals denied the writ of mandate. The defendants in those Related Actions sought review by the California Supreme Court, which declined to review the matter. Upon the return of the matter to the Los Angeles County Superior Court, motions for summary judgment were scheduled. Health Net California's motion for summary judgment was heard by the Court in March 2020. In March 2020, the Court granted Health Net California's motion for summary judgment. In April 2023, the California Court of Appeals affirmed the grant of summary judgment in Health Net California's favor. In June 2023, plaintiff filed a petition for review with the California Supreme Court, which was denied in July 2023. Beginning in April 2021, several lawsuits have been filed against the Company and its subsidiaries, alleging that the defendants failed to prevent Health Net members' personal and health data from being exposed in connection with a data breach involving Accellion's File Transfer Appliance. The Company denies any wrongdoing, and at a mediation in September 2021, the Company reached a settlement with plaintiffs in three of the pending class actions which, if approved by court, should resolve most or all of the pending litigation related to this matter. In addition, claims related to these lawsuits are anticipated to be covered in part by the Company's insurance carrier. As a result, while these matters are subject to many uncertainties, the Company does not believe that an adverse outcome in these matters is likely to have a materially adverse impact on the Company's financial condition, results of operations and cash flows. Pharmacy Benefits Management Matters On March 11, 2021, the State of Ohio filed a civil action against the Company and the Company's subsidiaries, Buckeye Health Plan Community Solutions, Inc. and Envolve, in Franklin County Court of Common Pleas, captioned as Ohio Department of Medicaid, et al. v. Centene Corporation, et al. The complaint alleged breaches of contract with the Ohio Department of Medicaid relating to the provision of PBM services and violations of Ohio law relating to such contracts, including among other things, by (i) seeking payment for services already reimbursed, (ii) not accurately disclosing to the Ohio Department of Medicaid the true cost of the PBM services and (iii) inflating dispensing fees for prescription drugs. The plaintiffs sought an undisclosed sum of money in damages, penalties, and possible termination of the contract with Buckeye Health Plan. The Company has reached a no-fault settlement with the Ohio Attorney General regarding this matter and the complaint was dismissed. The Company has reached no-fault settlement agreements with the Attorneys General in other states to resolve claims and/or allegations made by those states related to services previously provided by Envolve. Additionally, the Company is in discussions to bring final resolution to similar concerns in other affected states. Consistent with those discussions, the Company recorded a reserve estimate of $1,250 million in the second quarter of 2021 related to this issue, inclusive of the above settlements and rebates that the Company determined in the course of the matter are payable across products. Additional claims, reviews or investigations relating to the Company's historical PBM business across products may be brought by other states, the federal government, or shareholder litigants, and there is no guarantee the Company will have the ability to settle such claims with other states within the reserve estimate the Company has recorded and on other acceptable terms, or at all. This matter is subject to many uncertainties, and an adverse outcome in this matter could have an adverse impact on the Company's financial condition, results of operations and cash flows.

Organization and Operations (Po

Organization and Operations (Policies)	6 Months Ended
	Jun. 30, 2023
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Basis of Presentation	Basis of Presentation The accompanying interim financial statements have been prepared under the presumption that users of the interim financial information have either read or have access to the audited financial statements included in the Form 10-K for the fiscal year ended December 31, 2022. The unaudited interim financial statements herein have been prepared pursuant to the rules and regulations of the Securities and Exchange Commission. Accordingly, footnote disclosures that would substantially duplicate the disclosures contained in the December 31, 2022 audited financial statements have been omitted from these interim financial statements, where appropriate. In the opinion of management, these financial statements reflect all adjustments, consisting only of normal recurring adjustments, which are necessary for a fair presentation of the results of the interim periods presented. Certain 2022 amounts in the consolidated financial statements and notes to the consolidated financial statements have been reclassified to conform to the 2023 presentation, including reclassifications related to the Company's new segment reporting structure as outlined below. These reclassifications have no effect on net earnings or stockholders' equity as previously reported.
Segment Reporting	Segment Reporting In the first quarter of 2023, and in conjunction with the Company's updated strategic plan, executive leadership realignment, and corresponding 2023 divestitures, the Company revised the way it manages the business, evaluates performance, and allocates resources, resulting in an updated segment structure comprised of (1) a Medicaid segment, (2) a Medicare segment, (3) a Commercial segment, and (4) an Other segment. The Medicaid, Medicare, and Commercial segments represent the government-sponsored or subsidized programs under which the Company offers managed healthcare services. Specifically, the Medicaid segment includes the Temporary Assistance for Needy Families (TANF) program, Medicaid Expansion programs, the Aged, Blind, or Disabled (ABD) program, the Children's Health Insurance Program (CHIP), Long-Term Services and Supports (LTSS), Foster Care, Medicare-Medicaid Plans (MMP), which cover beneficiaries who are dually eligible for Medicaid and Medicare, and other state-based programs. The Medicare segment includes Medicare Advantage, Medicare Supplement, Dual Eligible Special Needs Plans (D-SNPs), and Medicare Prescription Drug Plans (PDPs), also known as Medicare Part D. The Commercial segment includes the Health Insurance Marketplace along with individual, small group, and large group commercial healthcare products. The Other segment includes the Company's pharmacy operations, vision and dental services, clinical healthcare, behavioral health, international operations, and corporate management companies, among others.
Accounting Guidance Not Yet Adopted	Accounting Guidance Not Yet Adopted The Company has determined that there are no recently issued accounting pronouncements that will have a material impact on its consolidated financial position, results of operations, or cash flows.

Short-term and Long-term Inve_2

Short-term and Long-term Investments, Restricted Deposits (Tables)	6 Months Ended
	Jun. 30, 2023
Investments, Debt and Equity Securities [Abstract]
Short-term and long-term investments and restricted deposits by investment type	Short-term and long-term investments and restricted deposits by investment type consist of the following ($ in millions): June 30, 2023 December 31, 2022 Amortized Cost Gross Gross Fair Value Amortized Cost Gross Gross Fair Value Debt securities: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 465 $ — $ (15) $ 450 $ 695 $ — $ (16) $ 679 Corporate securities 10,578 13 (724) 9,867 10,127 12 (778) 9,361 Restricted certificates of deposit 4 — — 4 4 — — 4 Restricted cash equivalents 358 — — 358 256 — — 256 Short-term time deposits 419 — — 419 204 — — 204 Municipal securities 4,156 9 (234) 3,931 4,055 6 (280) 3,781 Asset-backed securities 1,507 1 (60) 1,448 1,396 — (70) 1,326 Residential mortgage-backed securities 1,346 1 (120) 1,227 1,165 2 (121) 1,046 Commercial mortgage-backed securities 1,081 — (100) 981 961 — (99) 862 Equity securities 2 — — 2 5 — — 5 Private equity investments 805 — — 805 529 — — 529 Life insurance contracts 183 — — 183 169 — — 169 Total $ 20,904 $ 24 $ (1,253) $ 19,675 $ 19,566 $ 20 $ (1,364) $ 18,222
Fair value of available-for-sale investments with gross unrealized losses by investment type and length of time	The fair value of available-for-sale debt securities with gross unrealized losses by investment type and length of time that individual securities have been in a continuous unrealized loss position were as follows ($ in millions): June 30, 2023 December 31, 2022 Less Than 12 Months 12 Months or More Less Than 12 Months 12 Months or More Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value Unrealized Losses Fair Value U.S. Treasury securities and obligations of U.S. government corporations and agencies $ (3) $ 207 $ (12) $ 191 $ (5) $ 342 $ (11) $ 184 Corporate securities (73) 2,942 (651) 6,049 (340) 5,368 (438) 3,400 Municipal securities (26) 1,413 (208) 1,990 (142) 2,437 (138) 995 Asset-backed securities (8) 431 (52) 949 (29) 786 (41) 486 Residential mortgage-backed securities (16) 494 (104) 644 (55) 629 (66) 352 Commercial mortgage-backed securities (8) 224 (92) 736 (49) 513 (50) 330 Total $ (134) $ 5,711 $ (1,119) $ 10,559 $ (620) $ 10,075 $ (744) $ 5,747
Contractual maturities of short-term and long-term investments and restricted deposits	The contractual maturities of short-term and long-term debt securities and restricted deposits are as follows ($ in millions): June 30, 2023 December 31, 2022 Investments Restricted Deposits Investments Restricted Deposits Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value Amortized Cost Fair Value One year or less $ 2,095 $ 2,064 $ 627 $ 625 $ 2,207 $ 2,179 $ 534 $ 532 One year through five years 8,144 7,630 509 477 7,651 7,147 524 490 Five years through ten years 4,169 3,826 254 232 4,066 3,613 224 195 Greater than ten years 160 154 22 21 135 129 — — Asset-backed securities 3,934 3,656 — — 3,522 3,234 — — Total $ 18,502 $ 17,330 $ 1,412 $ 1,355 $ 17,581 $ 16,302 $ 1,282 $ 1,217

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2023
Fair Value Disclosures [Abstract]
Assets and Liabilities, Based Upon Observable or Unobservable Inputs, Level Input Definitions	Assets and liabilities recorded at fair value in the Consolidated Balance Sheets are categorized based upon observable or unobservable inputs used to estimate fair value. Level inputs are as follows: Level Input: Input Definition: Level I Inputs are unadjusted, quoted prices for identical assets or liabilities in active markets at the measurement date. Level II Inputs other than quoted prices included in Level I that are observable for the asset or liability through corroboration with market data at the measurement date. Level III Unobservable inputs that reflect management's best estimate of what market participants would use in pricing the asset or liability at the measurement date.
Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis	The following table summarizes fair value measurements by level at June 30, 2023, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 17,170 $ — $ — $ 17,170 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 112 $ — $ — $ 112 Corporate securities — 9,833 — 9,833 Municipal securities — 3,310 — 3,310 Short-term time deposits — 419 — 419 Asset-backed securities — 1,448 — 1,448 Residential mortgage-backed securities — 1,227 — 1,227 Commercial mortgage-backed securities — 981 — 981 Equity securities — 2 — 2 Total investments $ 112 $ 17,220 $ — $ 17,332 Restricted deposits: Cash and cash equivalents $ 358 $ — $ — $ 358 U.S. Treasury securities and obligations of U.S. government corporations and agencies 338 — — 338 Corporate securities — 34 — 34 Certificates of deposit — 4 — 4 Municipal securities — 621 — 621 Total restricted deposits $ 696 $ 659 $ — $ 1,355 Total assets at fair value $ 17,978 $ 17,879 $ — $ 35,857 The following table summarizes fair value measurements by level at December 31, 2022, for assets and liabilities measured at fair value on a recurring basis ($ in millions): Level I Level II Level III Total Assets Cash and cash equivalents $ 12,074 $ — $ — $ 12,074 Investments: U.S. Treasury securities and obligations of U.S. government corporations and agencies $ 366 $ 5 $ — $ 371 Corporate securities — 9,328 — 9,328 Municipal securities — 3,165 — 3,165 Short-term time deposits — 204 — 204 Asset backed securities — 1,326 — 1,326 Residential mortgage-backed securities — 1,046 — 1,046 Commercial mortgage-backed securities — 862 — 862 Equity securities 3 2 — 5 Total investments $ 369 $ 15,938 $ — $ 16,307 Restricted deposits: Cash and cash equivalents $ 256 $ — $ — $ 256 U.S. Treasury securities and obligations of U.S. government corporations and agencies 308 — — 308 Corporate securities — 33 — 33 Certificates of deposit — 4 — 4 Municipal securities — 616 — 616 Total restricted deposits $ 564 $ 653 $ — $ 1,217 Total assets at fair value $ 13,007 $ 16,591 $ — $ 29,598

Goodwill and Intangible Assets

Goodwill and Intangible Assets (Tables)	6 Months Ended
	Jun. 30, 2023
Goodwill and Intangible Assets Disclosure [Abstract]
Schedule of Goodwill	The following table summarizes the changes in goodwill by operating segment ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, December 31, 2021 $ 10,194 $ 1,592 $ 5,424 $ 2,561 $ 19,771 Acquisition and purchase accounting adjustments — — — 1,077 1,077 Divestitures — — — (1,533) (1,533) Reallocation 4 — — (4) — Impairments — — — (370) (370) Translation impact — — — (133) (133) Balance, December 31, 2022 $ 10,198 $ 1,592 $ 5,424 $ 1,598 $ 18,812 Divestitures — — — (152) (152) Translation impact — — — 56 56 Balance, June 30, 2023 $ 10,198 $ 1,592 $ 5,424 $ 1,502 $ 18,716

Medical Claims Liability (Table

Medical Claims Liability (Tables)	6 Months Ended
	Jun. 30, 2023
Insurance [Abstract]
Schedule of change in medical claims liability	The following table summarizes the change in medical claims liability for the six months ended June 30, 2023 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2023 $ 11,253 $ 3,431 $ 1,921 $ 140 $ 16,745 Less: Reinsurance recoverable 7 — 19 — 26 Balance, January 1, 2023, net 11,246 3,431 1,902 140 16,719 Incurred related to: Current year 40,622 10,083 8,857 773 60,335 Prior years (1,153) (191) (208) (2) (1,554) Total incurred 39,469 9,892 8,649 771 58,781 Paid related to: Current year 31,837 7,726 6,751 656 46,970 Prior years 7,890 2,357 1,282 137 11,666 Total paid 39,727 10,083 8,033 793 58,636 Balance, June 30, 2023, net 10,988 3,240 2,518 118 16,864 Plus: Reinsurance recoverable 5 — 15 — 20 Balance, June 30, 2023 $ 10,993 $ 3,240 $ 2,533 $ 118 $ 16,884 The following table summarizes the change in medical claims liability for the six months ended June 30, 2022 ($ in millions): Medicaid Medicare Commercial Other Consolidated Total Balance, January 1, 2022 $ 9,845 $ 2,286 $ 2,014 $ 98 $ 14,243 Less: Reinsurance recoverable 23 — — — 23 Balance, January 1, 2022, net 9,822 2,286 2,014 98 14,220 Acquisitions and divestitures — — — 249 249 Incurred related to: Current year 37,803 9,918 7,001 1,457 56,179 Prior years (770) (46) (198) (15) (1,029) Total incurred 37,033 9,872 6,803 1,442 55,150 Paid related to: Current year 29,007 6,977 5,475 1,427 42,886 Prior years 6,808 1,784 1,489 80 10,161 Total paid 35,815 8,761 6,964 1,507 53,047 Balance, June 30, 2022, net 11,040 3,397 1,853 282 16,572 Plus: Reinsurance recoverable 9 — — — 9 Balance, June 30, 2022 $ 11,049 $ 3,397 $ 1,853 $ 282 $ 16,581

Affordable Care Act (Tables)

Affordable Care Act (Tables)	6 Months Ended
	Jun. 30, 2023
Affordable Care Act [Abstract]
Schedule of net receivables (payables) related to the Affordable Care Act Programs	The Company's net receivables (payables) for each of the programs are as follows ($ in millions): June 30, 2023 December 31, 2022 Risk adjustment receivable $ 1,088 $ 838 Risk adjustment payable (2,303) (780) Minimum medical loss ratio (233) (103) Cost sharing reduction receivable 2 — Cost sharing reduction payable (87) (99)

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2023
Debt Disclosure [Abstract]
Schedule of Debt	Debt consists of the following ($ in millions): June 30, 2023 December 31, 2022 $2,500 million 4.25% Senior Notes due December 15, 2027 $ 2,394 $ 2,393 $2,300 million 2.45% Senior Notes due July 15, 2028 2,303 2,303 $3,500 million 4.625% Senior Notes due December 15, 2029 3,277 3,277 $2,000 million 3.375% Senior Notes due February 15, 2030 2,000 2,000 $2,200 million 3.00% Senior Notes due October 15, 2030 2,200 2,200 $2,200 million 2.50% Senior Notes due March 1, 2031 2,200 2,200 $1,300 million 2.625% Senior Notes due August 1, 2031 1,300 1,300 Total senior notes 15,674 15,673 Term loan facility 2,156 2,183 Revolving credit agreement 61 58 Finance leases and other 250 253 Debt issuance costs (135) (147) Total debt 18,006 18,020 Less: current portion (110) (82) Long-term debt $ 17,896 $ 17,938

Leases (Tables)

Leases (Tables)	6 Months Ended
	Jun. 30, 2023
Leases [Abstract]
ROU Assets and Liabilities	The following table sets forth the right-of-use (ROU) assets and lease liabilities ($ in millions): June 30, 2023 December 31, 2022 Assets ROU assets (recorded within other long-term assets) $ 2,613 $ 2,554 Liabilities Short-term (recorded within accounts payable and accrued expenses) $ 176 $ 180 Long-term (recorded within other long-term liabilities) 3,171 3,133 Total lease liabilities $ 3,347 $ 3,313

Stockholders' Equity (Tables)

Stockholders' Equity (Tables)	6 Months Ended
	Jun. 30, 2023
Equity [Abstract]
Class of Treasury Stock	The following represents the Company's share repurchase activity ($ in millions, shares in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Shares Cost Shares Cost Shares Cost Shares Cost Share buybacks 6,028 $ 400 4,188 $ 344 10,880 $ 777 4,188 $ 344 Income tax withholding 71 5 61 5 767 51 907 76 Total share repurchases (1) 6,099 $ 405 4,249 $ 349 11,647 $ 828 5,095 $ 420 (1) Excludes share repurchase excise tax of $3 million accrued as of June 30, 2023.

Earnings Per Share (Tables)

Earnings Per Share (Tables)	6 Months Ended
	Jun. 30, 2023
Earnings Per Share [Abstract]
Calculation of Basic and Diluted Net Earnings Per Common Share	The following table sets forth the calculation of basic and diluted net earnings (loss) per common share ($ in millions, except per share data in dollars and shares in thousands): Three Months Ended June 30, Six Months Ended June 30, 2023 2022 2023 2022 Earnings (loss) attributable to Centene Corporation $ 1,058 $ (172) $ 2,188 $ 677 Shares used in computing per share amounts: Weighted average number of common shares outstanding 548,932 583,644 549,850 583,435 Common stock equivalents (as determined by applying the treasury stock method) (1) 1,376 — 2,146 6,791 Weighted average number of common shares and potential dilutive common shares outstanding 550,308 583,644 551,996 590,226 Net earnings (loss) per common share attributable to Centene Corporation: Basic earnings (loss) per common share $ 1.93 $ (0.29) $ 3.98 $ 1.16 Diluted earnings (loss) per common share $ 1.92 $ (0.29) $ 3.96 $ 1.15 (1) The reduction in common stock equivalents is primarily driven by the distribution of long-term stock awards to the estate of the Company's former CEO during the first quarter of 2023, which were fully dilutive prior to their distribution.

Segment Information (Tables)

Segment Information (Tables)	6 Months Ended
	Jun. 30, 2023
Segment Reporting [Abstract]
Segment Information	Segment information for the three months ended June 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 21,895 $ 5,665 $ 5,734 $ 419 $ 33,713 Service — — — 1,125 1,125 Premium and service revenues 21,895 5,665 5,734 1,544 34,838 Premium tax 2,770 — — — 2,770 Total external revenues 24,665 5,665 5,734 1,544 37,608 Internal revenues — — — 3,789 3,789 Eliminations — — — (3,789) (3,789) Total revenues $ 24,665 $ 5,665 $ 5,734 $ 1,544 $ 37,608 Medical costs $ 19,459 $ 4,884 $ 4,644 $ 360 $ 29,347 Cost of services $ 2 $ — $ — $ 875 $ 877 Gross margin (1) $ 2,434 $ 781 $ 1,090 $ 309 $ 4,614 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the three months ended June 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 20,488 $ 5,639 $ 4,554 $ 829 $ 31,510 Service (1) — 1 2,458 2,458 Premium and service revenues 20,487 5,639 4,555 3,287 33,968 Premium tax 1,968 — — — 1,968 Total external revenues 22,455 5,639 4,555 3,287 35,936 Internal revenues — — — 5,986 5,986 Eliminations — — — (5,986) (5,986) Total revenues $ 22,455 $ 5,639 $ 4,555 $ 3,287 $ 35,936 Medical costs $ 18,258 $ 4,826 $ 3,529 $ 699 $ 27,312 Cost of services $ — $ — $ — $ 2,099 $ 2,099 Gross margin (1) $ 2,229 $ 813 $ 1,026 $ 489 $ 4,557 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the six months ended June 30, 2023, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 44,122 $ 11,541 $ 10,986 $ 889 $ 67,538 Service — — — 2,252 2,252 Premium and service revenues 44,122 11,541 10,986 3,141 69,790 Premium tax 6,707 — — — 6,707 Total external revenues 50,829 11,541 10,986 3,141 76,497 Internal revenues — — — 7,656 7,656 Eliminations — — — (7,656) (7,656) Total revenues $ 50,829 $ 11,541 $ 10,986 $ 3,141 $ 76,497 Medical costs $ 39,469 $ 9,892 $ 8,649 $ 771 $ 58,781 Cost of services $ 2 $ — $ — $ 1,745 $ 1,747 Gross margin (1) $ 4,651 $ 1,649 $ 2,337 $ 625 $ 9,262 (1) Gross margin represents premium and service revenues less medical costs and cost of services. Segment information for the six months ended June 30, 2022, is as follows ($ in millions): Medicaid Medicare Commercial Other/Eliminations Consolidated Total Premium $ 41,609 $ 11,396 $ 8,686 $ 1,708 $ 63,399 Service (1) — 1 4,801 4,801 Premium and service revenues 41,608 11,396 8,687 6,509 68,200 Premium tax 4,921 — — — 4,921 Total external revenues 46,529 11,396 8,687 6,509 73,121 Internal revenues — — — 12,436 12,436 Eliminations — — — (12,436) (12,436) Total revenues $ 46,529 $ 11,396 $ 8,687 $ 6,509 $ 73,121 Medical costs $ 37,033 $ 9,872 $ 6,803 $ 1,442 $ 55,150 Cost of services $ — $ — $ — $ 4,087 $ 4,087 Gross margin (1) $ 4,575 $ 1,524 $ 1,884 $ 980 $ 8,963 (1) Gross margin represents premium and service revenues less medical costs and cost of services.

Acquisitions and Divestitures -

Acquisitions and Divestitures -Divestiture (Details) - USD ($) $ in Millions			1 Months Ended	3 Months Ended		6 Months Ended		12 Months Ended
	Jun. 13, 2023	Jan. 20, 2023	Apr. 30, 2023	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022	Dec. 31, 2022
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on divestiture						$ 172	$ 0
Impairment charge				$ 18	$ 1,450	$ 38	$ 1,450
Centurion | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on divestiture				15
Magellan Specialty Health | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on divestiture		$ 79
Consideration received on divestiture		646
Proceeds from sale of business			$ 245
Contingent consideration on disposal (up to)		$ 150
Spanish and Central European Businesses | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on divestiture				$ 13
Impairment charge								$ (163)
Impairment charge, net of tax								$ (140)
Apixio | Disposal Group, Disposed of by Sale, Not Discontinued Operations
Income Statement, Balance Sheet and Additional Disclosures by Disposal Groups, Including Discontinued Operations [Line Items]
Gain on disposal	$ 91
Gain on disposal, net of tax	$ 63

Short-term and Long-term Inve_3

Short-term and Long-term Investments, Restricted Deposits - By Investment Type (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Debt Securities
Gross Unrealized Gains	$ 24	$ 20
Gross Unrealized Losses	(1,253)	(1,364)
Equity securities	2	5
Private equity investments	805	529
Life insurance contracts	183	169
Total, Amortized Cost	20,904	19,566
Total, Fair Value	19,675	18,222
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Debt Securities
Amortized Cost	465	695
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(15)	(16)
Fair Value	450	679
Corporate securities
Debt Securities
Amortized Cost	10,578	10,127
Gross Unrealized Gains	13	12
Gross Unrealized Losses	(724)	(778)
Fair Value	9,867	9,361
Restricted certificates of deposit
Debt Securities
Amortized Cost	4	4
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	4	4
Restricted cash equivalents
Debt Securities
Amortized Cost	358	256
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	358	256
Short-term time deposits
Debt Securities
Amortized Cost	419	204
Gross Unrealized Gains	0	0
Gross Unrealized Losses	0	0
Fair Value	419	204
Municipal securities
Debt Securities
Amortized Cost	4,156	4,055
Gross Unrealized Gains	9	6
Gross Unrealized Losses	(234)	(280)
Fair Value	3,931	3,781
Asset-backed securities
Debt Securities
Amortized Cost	1,507	1,396
Gross Unrealized Gains	1	0
Gross Unrealized Losses	(60)	(70)
Fair Value	1,448	1,326
Residential mortgage-backed securities
Debt Securities
Amortized Cost	1,346	1,165
Gross Unrealized Gains	1	2
Gross Unrealized Losses	(120)	(121)
Fair Value	1,227	1,046
Commercial mortgage-backed securities
Debt Securities
Amortized Cost	1,081	961
Gross Unrealized Gains	0	0
Gross Unrealized Losses	(100)	(99)
Fair Value	$ 981	$ 862

Short-term and Long-term Inve_4

Short-term and Long-term Investments, Restricted Deposits - Narrative (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($) position	Dec. 31, 2022 USD ($)
Schedule Of Investments And Restricted Deposits By Type [Line Items]
Accrued interest income | $	$ 149	$ 132
Positions from which gross unrealized losses were generated	6,392
Total investment positions	6,910
Commercial mortgage-backed securities
Schedule Of Investments And Restricted Deposits By Type [Line Items]
Investments recorded at fair value that carry rating of AAA Plus, weighted average (in years)	4 years
Rated Securities | External Credit Rating, Investment Grade | Investment Securities
Schedule Of Investments And Restricted Deposits By Type [Line Items]
Percentage of investments in rated securities carry an investment grade rating by nationally recognized statistical rating organizations	99%

Short-term and Long-term Inve_5

Short-term and Long-term Investments, Restricted Deposits - Fair Value of Available-For-Sale Investments with Gross Unrealized Losses by Investment Type and Length of Time (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Unrealized Losses
Less Than 12 Months	$ (134)	$ (620)
12 Months or More	(1,119)	(744)
Fair Value
Fair Value, Less Than 12 Months	5,711	10,075
Fair Value, 12 Months or More	10,559	5,747
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Unrealized Losses
Less Than 12 Months	(3)	(5)
12 Months or More	(12)	(11)
Fair Value
Fair Value, Less Than 12 Months	207	342
Fair Value, 12 Months or More	191	184
Corporate securities
Unrealized Losses
Less Than 12 Months	(73)	(340)
12 Months or More	(651)	(438)
Fair Value
Fair Value, Less Than 12 Months	2,942	5,368
Fair Value, 12 Months or More	6,049	3,400
Municipal securities
Unrealized Losses
Less Than 12 Months	(26)	(142)
12 Months or More	(208)	(138)
Fair Value
Fair Value, Less Than 12 Months	1,413	2,437
Fair Value, 12 Months or More	1,990	995
Asset-backed securities
Unrealized Losses
Less Than 12 Months	(8)	(29)
12 Months or More	(52)	(41)
Fair Value
Fair Value, Less Than 12 Months	431	786
Fair Value, 12 Months or More	949	486
Residential mortgage-backed securities
Unrealized Losses
Less Than 12 Months	(16)	(55)
12 Months or More	(104)	(66)
Fair Value
Fair Value, Less Than 12 Months	494	629
Fair Value, 12 Months or More	644	352
Commercial mortgage-backed securities
Unrealized Losses
Less Than 12 Months	(8)	(49)
12 Months or More	(92)	(50)
Fair Value
Fair Value, Less Than 12 Months	224	513
Fair Value, 12 Months or More	$ 736	$ 330

Short-term and Long-term Inve_6

Short-term and Long-term Investments, Restricted Deposits - Contractual Maturities of Short-Term and Long-Term Investments and Restricted Deposits (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Investments
Amortized Cost
One year or less	$ 2,095	$ 2,207
One year through five years	8,144	7,651
Five years through ten years	4,169	4,066
Greater than ten years	160	135
Asset-backed securities	3,934	3,522
Amortized Cost	18,502	17,581
Fair Value
One year or less	2,064	2,179
One year through five years	7,630	7,147
Five years through ten years	3,826	3,613
Greater than ten years	154	129
Asset-backed securities	3,656	3,234
Fair Value	17,330	16,302
Restricted Deposits
Amortized Cost
One year or less	627	534
One year through five years	509	524
Five years through ten years	254	224
Greater than ten years	22	0
Asset-backed securities	0	0
Amortized Cost	1,412	1,282
Fair Value
One year or less	625	532
One year through five years	477	490
Five years through ten years	232	195
Greater than ten years	21	0
Asset-backed securities	0	0
Fair Value	$ 1,355	$ 1,217

Fair Value Measurements - Fair

Fair Value Measurements - Fair Value Measurements by Level for Assets and Liabilities Measured at Fair Value on a Recurring Basis (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Assets
Cash and cash equivalents	$ 17,170	$ 12,074
Investments:
Equity securities	2	5
Total assets at fair value	35,857	29,598
U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	450	679
Corporate securities
Investments:
Fair Value	9,867	9,361
Municipal securities
Investments:
Fair Value	3,931	3,781
Short-term time deposits
Investments:
Fair Value	419	204
Asset-backed securities
Investments:
Fair Value	1,448	1,326
Residential mortgage-backed securities
Investments:
Fair Value	1,227	1,046
Commercial mortgage-backed securities
Investments:
Fair Value	981	862
Investments
Investments:
Fair Value	17,330	16,302
Total investments	17,332	16,307
Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	112	371
Investments | Corporate securities
Investments:
Fair Value	9,833	9,328
Investments | Municipal securities
Investments:
Fair Value	3,310	3,165
Investments | Short-term time deposits
Investments:
Fair Value	419	204
Investments | Asset-backed securities
Investments:
Fair Value	1,448	1,326
Investments | Residential mortgage-backed securities
Investments:
Fair Value	1,227	1,046
Investments | Commercial mortgage-backed securities
Investments:
Fair Value	981	862
Investments | Equity securities
Investments:
Equity securities	2	5
Restricted deposits
Investments:
Fair Value	1,355	1,217
Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	338	308
Restricted deposits | Corporate securities
Investments:
Fair Value	34	33
Restricted deposits | Municipal securities
Investments:
Fair Value	621	616
Restricted deposits | Cash and cash equivalents
Investments:
Fair Value	358	256
Restricted deposits | Certificates of deposit
Investments:
Fair Value	4	4
Level I
Assets
Cash and cash equivalents	17,170	12,074
Investments:
Total assets at fair value	17,978	13,007
Level I | Investments
Investments:
Total investments	112	369
Level I | Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	112	366
Level I | Investments | Corporate securities
Investments:
Fair Value	0	0
Level I | Investments | Municipal securities
Investments:
Fair Value	0	0
Level I | Investments | Short-term time deposits
Investments:
Fair Value	0	0
Level I | Investments | Asset-backed securities
Investments:
Fair Value	0	0
Level I | Investments | Residential mortgage-backed securities
Investments:
Fair Value	0	0
Level I | Investments | Commercial mortgage-backed securities
Investments:
Fair Value	0	0
Level I | Investments | Equity securities
Investments:
Equity securities	0	3
Level I | Restricted deposits
Investments:
Fair Value	696	564
Level I | Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	338	308
Level I | Restricted deposits | Corporate securities
Investments:
Fair Value	0	0
Level I | Restricted deposits | Municipal securities
Investments:
Fair Value	0	0
Level I | Restricted deposits | Cash and cash equivalents
Investments:
Fair Value	358	256
Level I | Restricted deposits | Certificates of deposit
Investments:
Fair Value	0	0
Level II
Assets
Cash and cash equivalents	0	0
Investments:
Total assets at fair value	17,879	16,591
Level II | Investments
Investments:
Total investments	17,220	15,938
Level II | Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	0	5
Level II | Investments | Corporate securities
Investments:
Fair Value	9,833	9,328
Level II | Investments | Municipal securities
Investments:
Fair Value	3,310	3,165
Level II | Investments | Short-term time deposits
Investments:
Fair Value	419	204
Level II | Investments | Asset-backed securities
Investments:
Fair Value	1,448	1,326
Level II | Investments | Residential mortgage-backed securities
Investments:
Fair Value	1,227	1,046
Level II | Investments | Commercial mortgage-backed securities
Investments:
Fair Value	981	862
Level II | Investments | Equity securities
Investments:
Equity securities	2	2
Level II | Restricted deposits
Investments:
Fair Value	659	653
Level II | Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	0	0
Level II | Restricted deposits | Corporate securities
Investments:
Fair Value	34	33
Level II | Restricted deposits | Municipal securities
Investments:
Fair Value	621	616
Level II | Restricted deposits | Cash and cash equivalents
Investments:
Fair Value	0	0
Level II | Restricted deposits | Certificates of deposit
Investments:
Fair Value	4	4
Level III
Assets
Cash and cash equivalents	0	0
Investments:
Total assets at fair value	0	0
Level III | Investments
Investments:
Total investments	0	0
Level III | Investments | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	0	0
Level III | Investments | Corporate securities
Investments:
Fair Value	0	0
Level III | Investments | Municipal securities
Investments:
Fair Value	0	0
Level III | Investments | Short-term time deposits
Investments:
Fair Value	0	0
Level III | Investments | Asset-backed securities
Investments:
Fair Value	0	0
Level III | Investments | Residential mortgage-backed securities
Investments:
Fair Value	0	0
Level III | Investments | Commercial mortgage-backed securities
Investments:
Fair Value	0	0
Level III | Investments | Equity securities
Investments:
Equity securities	0	0
Level III | Restricted deposits
Investments:
Fair Value	0	0
Level III | Restricted deposits | U.S. Treasury securities and obligations of U.S. government corporations and agencies
Investments:
Fair Value	0	0
Level III | Restricted deposits | Corporate securities
Investments:
Fair Value	0	0
Level III | Restricted deposits | Municipal securities
Investments:
Fair Value	0	0
Level III | Restricted deposits | Cash and cash equivalents
Investments:
Fair Value	0	0
Level III | Restricted deposits | Certificates of deposit
Investments:
Fair Value	$ 0	$ 0

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Fair Value Disclosures [Abstract]
Aggregate carrying amount of life insurance contracts and equity investments, fair value	$ 988	$ 698

Goodwill and Intangible Asset_2

Goodwill and Intangible Assets (Details) - USD ($) $ in Millions	6 Months Ended	12 Months Ended
	Jun. 30, 2023	Dec. 31, 2022
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill, Balance beginning	$ 18,812	$ 19,771
Acquisition and purchase accounting adjustments		1,077
Divestitures	(152)	(1,533)
Reallocation		0
Impairments		(370)
Translation impact	56	(133)
Goodwill, Balance ending	18,716	18,812
Medicaid
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill, Balance beginning	10,198	10,194
Acquisition and purchase accounting adjustments		0
Divestitures	0	0
Reallocation		4
Impairments		0
Translation impact	0	0
Goodwill, Balance ending	10,198	10,198
Medicare
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill, Balance beginning	1,592	1,592
Acquisition and purchase accounting adjustments		0
Divestitures	0	0
Reallocation		0
Impairments		0
Translation impact	0	0
Goodwill, Balance ending	1,592	1,592
Commercial
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill, Balance beginning	5,424	5,424
Acquisition and purchase accounting adjustments		0
Divestitures	0	0
Reallocation		0
Impairments		0
Translation impact	0	0
Goodwill, Balance ending	5,424	5,424
Other
Goodwill and Intangible Assets Disclosure [Abstract]
Goodwill, Balance beginning	1,598	2,561
Acquisition and purchase accounting adjustments		1,077
Divestitures	(152)	(1,533)
Reallocation		(4)
Impairments		(370)
Translation impact	56	(133)
Goodwill, Balance ending	$ 1,502	$ 1,598

Medical Claims Liability - Sche

Medical Claims Liability - Schedule of Change in Medical Claims Liability (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	$ 16,745	$ 14,243
Less: Reinsurance recoverable	26	23
Balance, January 1, net	16,719	14,220
Acquisitions and divestitures		249
Incurred related to:
Current year	60,335	56,179
Prior years	(1,554)	(1,029)
Total incurred	58,781	55,150
Paid related to:
Current year	46,970	42,886
Prior years	11,666	10,161
Total paid	58,636	53,047
Balance, June 30, net	16,864	16,572
Plus: Reinsurance recoverable	20	9
Balance, June 30	16,884	16,581
Medicaid
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	11,253	9,845
Less: Reinsurance recoverable	7	23
Balance, January 1, net	11,246	9,822
Acquisitions and divestitures		0
Incurred related to:
Current year	40,622	37,803
Prior years	(1,153)	(770)
Total incurred	39,469	37,033
Paid related to:
Current year	31,837	29,007
Prior years	7,890	6,808
Total paid	39,727	35,815
Balance, June 30, net	10,988	11,040
Plus: Reinsurance recoverable	5	9
Balance, June 30	10,993	11,049
Medicare
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	3,431	2,286
Less: Reinsurance recoverable	0	0
Balance, January 1, net	3,431	2,286
Acquisitions and divestitures		0
Incurred related to:
Current year	10,083	9,918
Prior years	(191)	(46)
Total incurred	9,892	9,872
Paid related to:
Current year	7,726	6,977
Prior years	2,357	1,784
Total paid	10,083	8,761
Balance, June 30, net	3,240	3,397
Plus: Reinsurance recoverable	0	0
Balance, June 30	3,240	3,397
Commercial
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	1,921	2,014
Less: Reinsurance recoverable	19	0
Balance, January 1, net	1,902	2,014
Acquisitions and divestitures		0
Incurred related to:
Current year	8,857	7,001
Prior years	(208)	(198)
Total incurred	8,649	6,803
Paid related to:
Current year	6,751	5,475
Prior years	1,282	1,489
Total paid	8,033	6,964
Balance, June 30, net	2,518	1,853
Plus: Reinsurance recoverable	15	0
Balance, June 30	2,533	1,853
Other
Liability for Unpaid Claims and Claims Adjustment Expense [Roll Forward]
Balance, January 1	140	98
Less: Reinsurance recoverable	0	0
Balance, January 1, net	140	98
Acquisitions and divestitures		249
Incurred related to:
Current year	773	1,457
Prior years	(2)	(15)
Total incurred	771	1,442
Paid related to:
Current year	656	1,427
Prior years	137	80
Total paid	793	1,507
Balance, June 30, net	118	282
Plus: Reinsurance recoverable	0	0
Balance, June 30	$ 118	$ 282

Medical Claims Liability - Narr

Medical Claims Liability - Narrative (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022
Insurance [Abstract]
Amounts recorded as an adjustment to premium revenues related to minimum HBR and return of premium programs	$ 319	$ 48
Short-duration insurance contracts, Incurred but not reported and expected development on reported claims	$ 11,360

Affordable Care Act - Net Recei

Affordable Care Act - Net Receivables (Payables) for Each of the Ongoing Programs (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Affordable Care Act [Abstract]
Risk adjustment receivable	$ 1,088	$ 838
Risk adjustment payable	(2,303)	(780)
Minimum medical loss ratio	(233)	(103)
Cost sharing reduction receivable	2	0
Cost sharing reduction payable	$ (87)	$ (99)

Affordable Care Act - Additiona

Affordable Care Act - Additional information (Details) $ in Millions	6 Months Ended
	Jun. 30, 2023 USD ($)
Affordable Care Act [Abstract]
Risk adjustment, increase to net receivables	$ 240
Risk adjustment and reinsurance pre-tax benefit	$ (196)

Debt - Schedule of Debt (Detail

Debt - Schedule of Debt (Details) - USD ($)	Jun. 30, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Total senior notes	$ 15,674,000,000	$ 15,673,000,000
Finance leases and other	250,000,000	253,000,000
Debt issuance costs	(135,000,000)	(147,000,000)
Total debt	18,006,000,000	18,020,000,000
Less: current portion	(110,000,000)	(82,000,000)
Long-term debt	17,896,000,000	17,938,000,000
Revolving credit agreement
Debt Instrument [Line Items]
Credit facility	61,000,000	58,000,000
Term loan facility
Debt Instrument [Line Items]
Credit facility	2,156,000,000	2,183,000,000
$2,500 million 4.25% Senior Notes due December 15, 2027 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,500,000,000
Interest rate	4.25%
Senior notes	$ 2,394,000,000	2,393,000,000
$2,300 million 2.45% Senior Notes due July 15, 2028 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,300,000,000
Interest rate	2.45%
Senior notes	$ 2,303,000,000	2,303,000,000
$3,500 million 4.625% Senior Notes due December 15, 2029 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 3,500,000,000
Interest rate	4.625%
Senior notes	$ 3,277,000,000	3,277,000,000
$2,000 million 3.375% Senior Notes due February 15, 2030 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,000,000,000
Interest rate	3.375%
Senior notes	$ 2,000,000,000	2,000,000,000
$2,200 million 3.00% Senior Notes due October 15, 2030 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,200,000,000
Interest rate	3%
Senior notes	$ 2,200,000,000	2,200,000,000
$2,200 million 2.50% Senior Notes due March 1, 2031 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 2,200,000,000
Interest rate	2.50%
Senior notes	$ 2,200,000,000	2,200,000,000
$1,300 million 2.625% Senior Notes due August 1, 2031 | Senior Notes
Debt Instrument [Line Items]
Debt, face amount	$ 1,300,000,000
Interest rate	2.625%
Senior notes	$ 1,300,000,000	$ 1,300,000,000

Leases - Right-of-use (ROU) Ass

Leases - Right-of-use (ROU) Assets and Lease Liabilities (Details) - USD ($) $ in Millions	Jun. 30, 2023	Dec. 31, 2022
Assets
ROU assets (recorded within other long-term assets)	$ 2,613	$ 2,554
Operating Lease, Right-of-Use Asset, Statement of Financial Position [Extensible List]	Other long-term assets	Other long-term assets
Liabilities
Short-term (recorded within accounts payable and accrued expenses)	$ 176	$ 180
Long-term (recorded within other long-term liabilities)	3,171	3,133
Total lease liabilities	$ 3,347	$ 3,313
Operating Lease, Liability, Current, Statement of Financial Position [Extensible List]	Accounts payable and accrued expenses	Accounts payable and accrued expenses
Operating Lease, Liability, Noncurrent, Statement of Financial Position [Extensible List]	Other long-term liabilities	Other long-term liabilities

Leases - Narrative (Details)

Leases - Narrative (Details)	Jun. 30, 2023
Lessee, Lease, Description [Line Items]
Weighted average remaining lease term	21 years
Weighted-average discount rate for operating leases	5.90%
Circle Health
Lessee, Lease, Description [Line Items]
Weighted average remaining lease term	27 years 3 months 18 days
Excluding Circle Health
Lessee, Lease, Description [Line Items]
Weighted average remaining lease term	8 years 4 months 24 days

Stockholders' Equity - Narrativ

Stockholders' Equity - Narrative (Details) - USD ($) shares in Millions, $ in Millions	1 Months Ended			3 Months Ended
	Jul. 28, 2023	Dec. 31, 2022	Jun. 30, 2022	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022
Equity, Class of Treasury Stock [Line Items]
Stock repurchase program, increase to authorized amount		$ 2,000	$ 3,000
Stock repurchase program, authorized amount				$ 6,000
Stock repurchase program, remaining available				2,029
Common stock repurchases				$ 408	$ 423	$ 349	$ 71
Subsequent Event
Equity, Class of Treasury Stock [Line Items]
Common stock repurchases (in shares)	4.5
Common stock repurchases	$ 300

Stockholders' Equity - Share Re

Stockholders' Equity - Share Repurchase Activity (Details) - USD ($) shares in Thousands, $ in Millions	3 Months Ended				6 Months Ended
	Jun. 30, 2023	Mar. 31, 2023	Jun. 30, 2022	Mar. 31, 2022	Jun. 30, 2023	Jun. 30, 2022
Subsidiary, Sale of Stock [Line Items]
Common stock repurchases	$ 408	$ 423	$ 349	$ 71
Stock repurchases, excise tax accrual	$ 3				$ 3
Employee Stock Compensation Plan
Subsidiary, Sale of Stock [Line Items]
Income tax withholding (in shares)	71		61		767	907
Income tax withholding	$ 5		$ 5		$ 51	$ 76
Common Stock
Subsidiary, Sale of Stock [Line Items]
Share buybacks (in shares)	6,028		4,188		10,880	4,188
Common stock repurchases (in shares)	6,099		4,249		11,647	5,095
Share buybacks	$ 400		$ 344		$ 777	$ 344
Common stock repurchases	$ 405		$ 349		$ 828	$ 420

Earnings Per Share (Details)

Earnings Per Share (Details) - USD ($) $ / shares in Units, shares in Thousands, $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Net Income (Loss) Attributable to Parent [Abstract]
Earnings (loss) attributable to Centene Corporation	$ 1,058	$ (172)	$ 2,188	$ 677
Shares used in computing per share amounts:
Weighted average number of common shares outstanding (in shares)	548,932	583,644	549,850	583,435
Common stock equivalents (as determined by applying the treasury stock method) (in shares)	1,376	0	2,146	6,791
Weighted average number of common shares and potential dilutive common shares outstanding (in shares)	550,308	583,644	551,996	590,226
Net earnings (loss) per common share attributable to Centene Corporation:
Basic earnings (loss) per common share (in dollars per share)	$ 1.93	$ (0.29)	$ 3.98	$ 1.16
Diluted earnings (loss) per common share (in dollars per share)	$ 1.92	$ (0.29)	$ 3.96	$ 1.15
Anti-dilutive restricted stock and restricted stock units excluded from the calculation of diluted earnings (loss) per common share (in shares)	2,000	6,000	2,000	226

Segment Information (Details)

Segment Information (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2023	Jun. 30, 2022	Jun. 30, 2023	Jun. 30, 2022
Segment Reporting Information [Line Items]
Premium and service revenues	$ 34,838	$ 33,968	$ 69,790	$ 68,200
Premium tax	2,770	1,968	6,707	4,921
Total external revenues	37,608	35,936	76,497	73,121
Revenues	37,608	35,936	76,497	73,121
Medical costs	29,347	27,312	58,781	55,150
Cost of services	877	2,099	1,747	4,087
Gross margin	4,614	4,557	9,262	8,963
Operating Segments
Segment Reporting Information [Line Items]
Revenues	3,789	5,986	7,656	12,436
Eliminations
Segment Reporting Information [Line Items]
Revenues	(3,789)	(5,986)	(7,656)	(12,436)
Premium
Segment Reporting Information [Line Items]
Premium and service revenues	33,713	31,510	67,538	63,399
Service
Segment Reporting Information [Line Items]
Premium and service revenues	1,125	2,458	2,252	4,801
Premium and service revenues
Segment Reporting Information [Line Items]
Premium and service revenues	34,838	33,968	69,790	68,200
Medicaid
Segment Reporting Information [Line Items]
Revenues	24,665	22,455	50,829	46,529
Medical costs	19,459	18,258	39,469	37,033
Cost of services	2	0	2	0
Gross margin	2,434	2,229	4,651	4,575
Medicaid | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	2,770	1,968	6,707	4,921
Total external revenues	24,665	22,455	50,829	46,529
Revenues	0	0	0	0
Medicaid | Eliminations
Segment Reporting Information [Line Items]
Revenues	0	0	0	0
Medicaid | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	21,895	20,488	44,122	41,609
Medicaid | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	0	(1)	0	(1)
Medicaid | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	21,895	20,487	44,122	41,608
Medicare
Segment Reporting Information [Line Items]
Revenues	5,665	5,639	11,541	11,396
Medical costs	4,884	4,826	9,892	9,872
Cost of services	0	0	0	0
Gross margin	781	813	1,649	1,524
Medicare | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0	0
Total external revenues	5,665	5,639	11,541	11,396
Revenues	0	0	0	0
Medicare | Eliminations
Segment Reporting Information [Line Items]
Revenues	0	0	0	0
Medicare | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	5,665	5,639	11,541	11,396
Medicare | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	0	0	0	0
Medicare | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	5,665	5,639	11,541	11,396
Commercial
Segment Reporting Information [Line Items]
Revenues	5,734	4,555	10,986	8,687
Medical costs	4,644	3,529	8,649	6,803
Cost of services	0	0	0	0
Gross margin	1,090	1,026	2,337	1,884
Commercial | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0	0
Total external revenues	5,734	4,555	10,986	8,687
Revenues	0	0	0	0
Commercial | Eliminations
Segment Reporting Information [Line Items]
Revenues	0	0	0	0
Commercial | Premium
Segment Reporting Information [Line Items]
Premium and service revenues	5,734	4,554	10,986	8,686
Commercial | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	0	1	0	1
Commercial | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	5,734	4,555	10,986	8,687
Other/Eliminations
Segment Reporting Information [Line Items]
Revenues	1,544	3,287	3,141	6,509
Medical costs	360	699	771	1,442
Cost of services	875	2,099	1,745	4,087
Gross margin	309	489	625	980
Other/Eliminations | Operating Segments
Segment Reporting Information [Line Items]
Premium tax	0	0	0	0
Total external revenues	1,544	3,287	3,141	6,509
Revenues	3,789	5,986	7,656	12,436
Other/Eliminations | Eliminations
Segment Reporting Information [Line Items]
Revenues	(3,789)	(5,986)	(7,656)	(12,436)
Other/Eliminations | Premium | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	419	829	889	1,708
Other/Eliminations | Service | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	1,125	2,458	2,252	4,801
Other/Eliminations | Premium and service revenues | Operating Segments
Segment Reporting Information [Line Items]
Premium and service revenues	$ 1,544	$ 3,287	$ 3,141	$ 6,509

Contingencies (Details)

Contingencies (Details) - Pending Litigation $ in Millions	Sep. 30, 2021 claim	Jun. 30, 2021 USD ($)
Loss Contingencies [Line Items]
Pending claims | claim	3
Reserve estimate | $		$ 1,250