Molina Healthcare (MOH) 10-Q 29 Jul 21 2021 Q2 Quarterly report Financial data

Cover Page

Cover Page - shares shares in Millions	6 Months Ended
	Jun. 30, 2021	Jul. 23, 2021
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Jun. 30, 2021
Document Transition Report	false
Entity File Number	001-31719
Entity Registrant Name	MOLINA HEALTHCARE, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	13-4204626
Entity Address, Address Line One	200 Oceangate
Entity Address, Address Line Two	Suite 100
Entity Address, City or Town	Long Beach,
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	90802
City Area Code	562
Local Phone Number	435-3666
Title of 12(b) Security	Common Stock, $0.001 Par Value
Trading Symbol	MOH
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		58.4
Entity Central Index Key	0001179929
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2021
Document Fiscal Period Focus	Q2
Amendment Flag	false

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Revenue:
Premium revenue	$ 6,583	$ 4,372	$ 12,889	$ 8,676
Premium tax revenue	185	157	372	307
Health insurer fees reimbursed	0	71	0	137
Investment income	10	13	19	38
Other revenue	22	5	42	9
Total revenue	6,800	4,618	13,322	9,167
Operating expenses:
Medical care costs	5,819	3,598	11,293	7,314
General and administrative expenses	484	345	957	662
Premium tax expenses	185	157	372	307
Health insurer fees	0	71	0	139
Depreciation and amortization	31	21	64	41
Other	8	2	28	6
Total operating expenses	6,527	4,194	12,714	8,469
Operating income	273	424	608	698
Other expenses, net:
Interest expense	30	24	60	45
Other expense, net	0	5	0	5
Total other expenses, net	30	29	60	50
Income before income tax expense	243	395	548	648
Income tax expense	58	119	135	194
Net income	$ 185	$ 276	$ 413	$ 454
Net income per share:
Net income per share - Basic (in dollars per share)	$ 3.20	$ 4.72	$ 7.14	$ 7.65
Net income per share - Diluted (in dollars per share)	$ 3.16	$ 4.65	$ 7.05	$ 7.54

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Statement of Comprehensive Income [Abstract]
Net income	$ 185	$ 276	$ 413	$ 454
Other comprehensive income (loss):
Unrealized investment income (loss)	1	62	(14)	37
Less: effect of income taxes	1	15	(3)	9
Other comprehensive income (loss), net of tax	0	47	(11)	28
Comprehensive income	$ 185	$ 323	$ 402	$ 482

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020
Current assets:
Cash and cash equivalents	$ 4,608	$ 4,154
Investments	2,241	1,875
Receivables	1,857	1,672
Prepaid expenses and other current assets	168	175
Total current assets	8,874	7,876
Property, equipment, and capitalized software, net	383	391
Goodwill, and intangible assets, net	929	941
Restricted investments	145	136
Deferred income taxes	65	69
Other assets	134	119
Total assets	10,530	9,532
Current liabilities:
Medical claims and benefits payable	2,942	2,696
Amounts due government agencies	2,072	1,253
Accounts payable, accrued liabilities and other	651	641
Deferred revenue	42	375
Total current liabilities	5,707	4,965
Long-term debt	2,129	2,127
Finance lease liabilities	223	225
Other long-term liabilities	101	119
Total liabilities	8,160	7,436
Stockholders’ equity:
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 58 million shares at June 30, 2021, and 59 million shares at December 31, 2020	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	191	199
Accumulated other comprehensive income	26	37
Retained earnings	2,153	1,860
Total stockholders’ equity	2,370	2,096
Total liabilities and stockholders’ equity	$ 10,530	$ 9,532

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Jun. 30, 2021	Dec. 31, 2020
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares outstanding (in shares)	58,000,000	59,000,000
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	20,000,000	20,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0

CONSOLIDATED STATEMENTS OF STOC

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Income	Retained Earnings
Beginning Balance (in shares) at Dec. 31, 2019	61.9	62
Beginning Balance at Dec. 31, 2019	$ 1,960	$ 0	$ 175	$ 4	$ 1,781
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	178				178
Common stock purchases (in shares)		(3)
Common stock purchases	(446)		(9)		(437)
Termination of warrants	(30)		(30)
Other comprehensive income (loss), net	(19)			(19)
Share-based compensation	$ 4		4
Ending Balance (in shares) at Mar. 31, 2020	58.6	59
Ending Balance at Mar. 31, 2020	$ 1,647	$ 0	140	(15)	1,522
Beginning Balance (in shares) at Dec. 31, 2019	61.9	62
Beginning Balance at Dec. 31, 2019	$ 1,960	$ 0	175	4	1,781
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	454
Other comprehensive income (loss), net	28
Ending Balance (in shares) at Jun. 30, 2020		59
Ending Balance at Jun. 30, 2020	$ 1,996	$ 0	166	32	1,798
Beginning Balance (in shares) at Mar. 31, 2020	58.6	59
Beginning Balance at Mar. 31, 2020	$ 1,647	$ 0	140	(15)	1,522
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	276				276
Other comprehensive income (loss), net	47			47
Share-based compensation	26		26
Ending Balance (in shares) at Jun. 30, 2020		59
Ending Balance at Jun. 30, 2020	$ 1,996	$ 0	166	32	1,798
Beginning Balance (in shares) at Dec. 31, 2020	58	59
Beginning Balance at Dec. 31, 2020	$ 2,096	$ 0	199	37	1,860
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	228				228
Common stock purchases (in shares)		(1)
Common stock purchases	(122)		(2)		(120)
Other comprehensive income (loss), net	(11)			(11)
Share-based compensation	$ (27)		(27)
Ending Balance (in shares) at Mar. 31, 2021	57.7	58
Ending Balance at Mar. 31, 2021	$ 2,164	$ 0	170	26	1,968
Beginning Balance (in shares) at Dec. 31, 2020	58	59
Beginning Balance at Dec. 31, 2020	$ 2,096	$ 0	199	37	1,860
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	413
Other comprehensive income (loss), net	(11)
Ending Balance (in shares) at Jun. 30, 2021		58
Ending Balance at Jun. 30, 2021	$ 2,370	$ 0	191	26	2,153
Beginning Balance (in shares) at Mar. 31, 2021	57.7	58
Beginning Balance at Mar. 31, 2021	$ 2,164	$ 0	170	26	1,968
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	185				185
Other comprehensive income (loss), net	0
Share-based compensation	21		21
Ending Balance (in shares) at Jun. 30, 2021		58
Ending Balance at Jun. 30, 2021	$ 2,370	$ 0	$ 191	$ 26	$ 2,153

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Operating activities:
Net income	$ 413	$ 454
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	64	41
Deferred income taxes	7	6
Share-based compensation	35	28
Loss on debt repayment	0	5
Other, net	10	(1)
Changes in operating assets and liabilities:
Receivables	(192)	(174)
Prepaid expenses and other current assets	(6)	(157)
Medical claims and benefits payable	272	106
Amounts due government agencies	792	201
Accounts payable, accrued liabilities and other	(15)	259
Deferred revenue	(333)	(195)
Income taxes	14	184
Net cash provided by operating activities	1,061	757
Investing activities:
Purchases of investments	(1,006)	(670)
Proceeds from sales and maturities of investments	622	750
Purchases of property, equipment and capitalized software	(29)	(45)
Other, net	5	3
Net cash (used in) provided by investing activities	(408)	38
Financing activities:
Common stock purchases	(128)	(453)
Common stock withheld to settle employee tax obligations	(52)	(8)
Contingent consideration liabilities settled	(20)	0
Proceeds from senior notes offering, net of issuance costs	0	789
Repayment of term loan facility	0	(600)
Proceeds from borrowings under term loan facility	0	380
Other, net	0	(45)
Net cash (used in) provided by financing activities	(200)	63
Net increase in cash, cash equivalents, and restricted cash and cash equivalents	453	858
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	4,223	2,508
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$ 4,676	$ 3,366

Organization and Basis of Prese

Organization and Basis of Presentation	6 Months Ended
	Jun. 30, 2021
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Basis of Presentation	Organization and Basis of Presentation Organization and Operations Molina Healthcare, Inc. provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces (the “Marketplace”). In the first quarter of 2021, we realigned our reportable operating segments to reflect recent changes in our internal operating and reporting structure, which is now organized by government program. These reportable segments consist of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. For further information, refer to Note 10, “Segments.” As of June 30, 2021, we served approximately 4.7 million members eligible for government-sponsored healthcare programs, located across 18 states. Our state Medicaid contracts typically have terms of three In addition to contract renewal, our state Medicaid contracts may be periodically amended to include or exclude certain health benefits (such as pharmacy services, behavioral health services, or long-term care services); populations such as the aged, blind or disabled (“ABD”); and regions or service areas. Recent Developments California Procurement—Medicaid. The state currently expects a final RFP to be released at the end of 2021. Texas Acquisition—Medicaid and Medicare. On April 22, 2021, we announced a definitive agreement to acquire Cigna Corporation’s Texas Medicaid and Medicare-Medicaid Plan (“MMP”) contracts, along with certain operating assets. As of December 31, 2020, Cigna served approximately 48,000 members in the Texas ABD program, also known as “STAR+PLUS,” in the Hidalgo, Tarrant and Northeast service areas, and approximately 2,000 MMP members in the Hidalgo service area, with full year 2020 premium revenue of approximately $1.0 billion. The purchase price for the transaction is approximately $60 million, which we intend to fund with cash on hand. The transaction is subject to receipt of applicable federal and state regulatory approvals and satisfaction of other customary closing conditions. We currently expect the transaction to close in January 2022. Ohio Procurement—Medicaid. On April 13, 2021, we announced that our Ohio health plan subsidiary was selected as an awardee in all three regions across the state pursuant to the Medicaid managed care request for award issued on September 30, 2020, by the Ohio Department of Medicaid. This new contract is expected to begin in early 2022, and will offer health care coverage to Medicaid beneficiaries through the state of Ohio’s Covered Family and Children, Expansion, and ABD programs. New York Acquisition—Medicaid. In September 2020, we entered into a definitive agreement to acquire substantially all of the assets of Affinity Health Plan, Inc., a Medicaid health plan in New York. The net purchase price for the transaction is approximately $380 million, subject to various adjustments at closing, which we intend to fund with cash on hand. We currently expect the transaction to close in the fourth quarter of 2021. Consolidation and Interim Financial Information The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the interim periods presented have been included; such adjustments consist of normal recurring adjustments. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the six months ended June 30, 2021 are not necessarily indicative of the results for the entire year ending December 31, 2021. The unaudited consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read or have access to our audited consolidated financial statements for the fiscal year ended December 31, 2020. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2020, audited consolidated financial statements have been omitted. These unaudited consolidated interim financial statements should be read in conjunction with our audited consolidated financial statements for the fiscal year ended December 31, 2020. Reclassifications Consistent with the change in reportable segments described above, certain prior year disclosures in Note 7, “Medical Claims and Benefits Payable,” and Note 10, “Segments,” have been recast to conform to the current year presentation. Certain immaterial amounts presented in the accompanying consolidated statement of cash flows for the six months ended June 30, 2020, have been reclassified to conform to the current year presentation. Use of Estimates The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates. Principal areas requiring the use of estimates include: • The determination of medical claims and benefits payable; • Contractual provisions that may limit revenue recognition based upon the costs incurred or the profits realized under a specific contract; • Quality incentives that allow us to recognize incremental revenue if certain quality standards are met; • Settlements under risk- or savings-sharing programs; • Purchase price allocations relating to business combinations, including the determination of contingent consideration; • The assessment of long-lived and intangible assets, and goodwill for impairment; • The determination of reserves for potential absorption of claims unpaid by insolvent providers; • The determination of reserves for the outcome of litigation; • The determination of valuation allowances for deferred tax assets; and

Significant Accounting Policies

Significant Accounting Policies	6 Months Ended
	Jun. 30, 2021
Accounting Policies [Abstract]
Significant Accounting Policies	Significant Accounting Policies Cash and Cash Equivalents Cash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase. The following table reconciles cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets. June 30, 2021 2020 (In millions) Cash and cash equivalents $ 4,608 $ 3,303 Restricted cash and cash equivalents 68 63 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,676 $ 3,366 Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made. June 30, December 31, (In millions) Government receivables $ 1,388 $ 969 Pharmacy rebate receivables 216 178 Health insurer fee reimbursement receivables 24 104 Other 229 255 Magellan Complete Care acquisition opening balance — 166 Total $ 1,857 $ 1,672 Premium Revenue Recognition and Amounts Due Government Agencies Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the Medicaid, Medicare, and Marketplace programs. Premium revenue is generally received based on per member per month (“PMPM”) rates established in advance of the periods covered. These premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. State Medicaid programs and the federal Medicare program periodically adjust premium rates. Certain components of premium revenue are subject to accounting estimates and are described in further detail below, and in our 2020 Annual Report on Form 10-K, Note 2, “Significant Accounting Policies,” under “Contractual Provisions That May Adjust or Limit Revenue or Profit,” and “Quality Incentives.” Contractual Provisions That May Adjust or Limit Revenue or Profit Many of our contracts contain provisions that may adjust or limit revenue or profit, which include those provisions with significant interim period balances described in further detail below. We recognize premium revenue as it is earned under such provisions. Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies,” in the accompanying consolidated balance sheets. Categorized by segment, such amounts due government agencies included the following: June 30, December 31, (In millions) Medicaid: Minimum MLR and profit sharing $ 774 $ 513 Other 208 76 Medicare: Risk adjustment and Part D risk sharing 88 45 Minimum MLR and profit sharing 136 62 Other 33 30 Marketplace: Risk adjustment 719 326 Minimum MLR 52 37 Other 62 21 Magellan Complete Care acquisition opening balance — 143 Total amounts due government agencies $ 2,072 $ 1,253 Medicaid Minimum MLR and Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, and is based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. Beginning in 2020, through June 30, 2021, various states enacted temporary risk corridors in response to the reduced demand for medical services stemming from COVID-19, which have resulted in a reduction of our medical margin. In some cases, these risk corridors were retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. Beginning in the second quarter of 2020, we have recognized retroactive risk corridors that we believe to be probable, and where the ultimate premium amount is reasonably estimable. For the three and six months ended June 30, 2021, we recognized approximately $56 million and $166 million, respectively, related to such risk corridors, primarily in the Medicaid segment. It is possible that certain states could increase the level of existing risk corridors, and other states could implement some form of risk corridors in the future. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a result of changes in facts or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows. Marketplace Risk Adjustment. Under this program, our health plans’ composite risk scores are compared with the overall average risk score for the relevant state and market pool. Generally, our health plans will make a risk adjustment payment into the pool if their composite risk scores are below the average risk score (risk adjustment payable), and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score (risk adjustment receivable). We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income. As of June 30, 2021, Marketplace risk adjustment payables amounted to $719 million and related receivables amounted to $40 million, for a net payable of $679 million, of which $414 million related to 2021, and $265 million related primarily to 2020. As of December 31, 2020, Marketplace risk adjustment payables amounted to $326 million and related receivables amounted to $20 million, for a net payable of $306 million. Concentrations of Credit Risk Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. Our investments consist primarily of investment-grade debt securities with final maturities of less than 10 years, or less than 10 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the federal government, and the local governments of the states in which our health plan subsidiaries operate. Income Taxes The provision for income taxes is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of foreign and state taxes, and nondeductible expenses such as certain compensation and other general and administrative expenses. The effective tax rate may be subject to fluctuations during the year as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including projected pretax earnings, the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers. Recent Accounting Pronouncements Various recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, and the Securities and Exchange Commission (“SEC”) did not

Net Income per Share

Net Income per Share	6 Months Ended
	Jun. 30, 2021
Earnings Per Share [Abstract]
Net Income per Share	Net Income per Share The following table sets forth the calculation of net income per share: Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (In millions, except net income per share) Numerator: Net income $ 185 $ 276 $ 413 $ 454 Denominator: Shares outstanding at the beginning of the period 57.7 58.6 58.0 61.9 Weighted-average number of shares issued: Stock purchases — — (0.5) (2.5) Stock-based compensation — — 0.2 — Denominator for basic net income per share 57.7 58.6 57.7 59.4 Effect of dilutive securities: (1) Stock-based compensation 0.7 0.8 0.8 0.8 Denominator for diluted net income per share 58.4 59.4 58.5 60.2 Net income per share - Basic (2) $ 3.20 $ 4.72 $ 7.14 $ 7.65 Net income per share - Diluted (2) $ 3.16 $ 4.65 $ 7.05 $ 7.54 ______________________________ (1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. (2) Source data for calculations in thousands.

Business Combinations

Business Combinations	6 Months Ended
	Jun. 30, 2021
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Business Combinations On December 31, 2020, we closed on our acquisition of 100% of the outstanding equity interests of the Magellan Complete Care line of business of Magellan Health, Inc., for total purchase consideration of approximately $1,037 million. In the six months ended June 30, 2021, we recorded various measurement period adjustments, including a decrease of $7 million to “Receivables,” a decrease of $26 million to “Medical claims and benefits payable,” and an increase of $27 million to “Amounts due government agencies.” In the aggregate, we recorded a net increase of $12 million to goodwill for these measurement period adjustments and various purchase price adjustments. Refer to Note 10, “Segments” for further information regarding the allocation of goodwill and intangible assets, net, by reportable segment.

Fair Value Measurements

Fair Value Measurements	6 Months Ended
	Jun. 30, 2021
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements We generally consider the carrying amounts of current assets and current liabilities to approximate their fair values because of the relatively short period of time between the origination of these instruments and their expected realization or payment. For our financial instruments measured at fair value on a recurring basis, we prioritize the inputs used in measuring fair value according to the three-tier fair value hierarchy. For a description of the methods and assumptions used to: a) estimate the fair value; and b) determine the classification according to the fair value hierarchy for each financial instrument, refer to our 2020 Annual Report on Form 10-K, Note 5, “Fair Value Measurements.” Our financial instruments measured at fair value on a recurring basis at June 30, 2021, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 1,393 $ — $ 1,393 $ — Mortgage-backed securities 548 — 548 — Asset-backed securities 176 — 176 — Municipal securities 75 — 75 — U.S. Treasury notes 26 — 26 — Other 23 — 23 — Total assets $ 2,241 $ — $ 2,241 $ — Contingent consideration liabilities $ 26 $ — $ — $ 26 Total liabilities $ 26 $ — $ — $ 26 Our financial instruments measured at fair value on a recurring basis at December 31, 2020, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 1,256 $ — $ 1,256 $ — Mortgage-backed securities 392 — 392 — Asset-backed securities 132 — 132 — Municipal securities 68 — 68 — U.S. Treasury notes 27 — 27 — Total assets $ 1,875 $ — $ 1,875 $ — Contingent consideration liabilities $ 46 $ — $ — $ 46 Total liabilities $ 46 $ — $ — $ 46 The net changes in fair value of Level 3 financial instruments are reported in “Other” operating expenses in our consolidated statements of income. In the six months ended June 30, 2021, we recognized a loss of $3 million for the increase in the fair value of the contingent consideration liabilities described below. Contingent Consideration Liabilities As of June 30, 2021, our Level 3 financial instruments recorded at fair value on a recurring basis included contingent consideration liabilities of $26 million, in connection with our 2020 acquisition of certain assets of Passport Health Plan, Inc., a Medicaid health plan in Kentucky. In the first quarter of 2021, the contingent purchase consideration relating to 2021 member enrollment was finalized and half the consideration due, or $23 million, was paid to the seller. The portion of the contingent purchase consideration paid in the first quarter of 2021 has been presented primarily in “Financing activities” in the accompanying consolidated statements of cash flows for the six months ended June 30, 2021, with the balance reflected in “Operating activities.” We expect to pay the remaining balance of the liabilities, reported in “Accounts payable, accrued liabilities and other” in the accompanying consolidated balance sheets, later in 2021 and in the first quarter of 2022. Fair Value Measurements – Disclosure Only The carrying amounts and estimated fair values of our notes payable are classified as Level 2 financial instruments. Fair value for these securities is determined using a market approach based on quoted market prices for similar securities in active markets or quoted prices for identical securities in inactive markets. June 30, 2021 December 31, 2020 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes $ 790 $ 835 $ 789 $ 843 5.375% Notes 698 733 697 742 3.875% Notes 641 678 641 691 Total $ 2,129 $ 2,246 $ 2,127 $ 2,276

Investments

Investments	6 Months Ended
	Jun. 30, 2021
Investments, Debt and Equity Securities [Abstract]
Investments	Investments Available-for-Sale We consider all our investments classified as current assets to be available-for-sale. The following tables summarize our investments as of the dates indicated: June 30, 2021 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,367 $ 26 $ — $ 1,393 Mortgage-backed securities 542 7 1 548 Asset-backed securities 174 2 — 176 Municipal securities 74 1 — 75 U.S. Treasury notes 26 — — 26 Other 23 — — 23 Total $ 2,206 $ 36 $ 1 $ 2,241 December 31, 2020 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,220 $ 36 $ — $ 1,256 Mortgage-backed securities 383 10 1 392 Asset-backed securities 130 2 — 132 Municipal securities 66 2 — 68 U.S. Treasury notes 27 — — 27 Total $ 1,826 $ 50 $ 1 $ 1,875 The contractual maturities of our available-for-sale investments as of June 30, 2021 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 312 $ 314 Due after one year through five years 1,200 1,225 Due after five years through ten years 264 267 Due after ten years 430 435 Total $ 2,206 $ 2,241 Gross realized gains and losses from sales of available-for-sale securities are calculated under the specific identification method and are included in investment income. Gross realized investment gains were insignificant for the three and six months ended June 30, 2021. Gross realized investment gains amounted to $1 million and $6 million for the three and six months ended June 30, 2020, respectively. Gross realized investment losses were insignificant for the three and six months ended June 30, 2021, and 2020. We have determined that unrealized losses at June 30, 2021, and December 31, 2020, primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. Therefore, we determined that an allowance for credit losses was not necessary. So long as we maintain the intent and ability to hold these securities to maturity, we are unlikely to experience losses. In the event that we dispose of these securities before maturity, we expect that realized losses, if any, will be insignificant. The following table summarizes those available-for-sale investments that have been in a continuous loss position for less than 12 months. No investments have been in a continuous loss position for 12 months or more as of June 30, 2021, and December 31, 2020. June 30, 2021 December 31, 2020 Estimated Unrealized Total Estimated Unrealized Total (Dollars in millions) Mortgage-backed securities $ 154 $ 1 62 $ 77 $ 1 21 Total $ 154 $ 1 62 $ 77 $ 1 21 Held-to-Maturity Pursuant to the regulations governing our state health plan subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in cash, cash equivalents, and U.S. Treasury securities. We also maintain restricted investments as protection against the insolvency of certain capitated providers. The use of these funds is limited as required by regulations in the various states in which we operate, or as needed in the event of insolvency of capitated providers. Therefore, such investments are reported as “Restricted investments” in the accompanying consolidated balance sheets. We have the ability to hold these restricted investments until maturity, and as a result, we would not expect the value of these investments to decline significantly due to a sudden change in market interest rates. Our held-to-maturity restricted investments are carried at amortized cost, which approximates fair value. Such investments amounted to $145 million at June 30, 2021, of which $137 million will mature in one year or less, and $8 million will mature in after one through five years.

Medical Claims and Benefits Pay

Medical Claims and Benefits Payable	6 Months Ended
	Jun. 30, 2021
Other Liabilities Disclosure [Abstract]
Medical Claims and Benefits Payable	Medical Claims and Benefits Payable The following table provides the details of our medical claims and benefits payable as of the dates indicated: June 30, December 31, (In millions) Fee-for-service claims incurred but not paid (“IBNP”) $ 2,120 $ 1,647 Pharmacy payable 221 157 Capitation payable 89 70 Other 512 528 Magellan Complete Care acquisition opening balance — 294 Total $ 2,942 $ 2,696 “Other” medical claims and benefits payable includes amounts payable to certain providers for which we act as an intermediary on behalf of various government agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. Non-risk provider payables amounted to $185 million and $235 million as of June 30, 2021, and December 31, 2020, respectively. The following table presents the components of the change in our medical claims and benefits payable for the periods indicated, with the prior period recast to conform to the current year presentation. The amounts presented for “Components of medical care costs related to: Prior years” represent decreases in medical care costs resulting from actual medical care costs being less than we previously estimated in the prior year. Six Months Ended June 30, 2021 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,129 $ 392 $ 175 $ 2,696 Components of medical care costs related to: Current year 8,869 1,459 1,158 11,486 Prior years (150) (24) (19) (193) Total medical care costs 8,719 1,435 1,139 11,293 Payments for medical care costs related to: Current year 7,043 1,111 869 9,023 Prior years 1,491 330 128 1,949 Total paid 8,534 1,441 997 10,972 Change in acquired balances (19) (7) — (26) Change in non-risk and other provider payables (48) (1) — (49) Medical claims and benefits payable, ending balance $ 2,247 $ 378 $ 317 $ 2,942 Six Months Ended June 30, 2020 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 1,465 $ 267 $ 122 $ 1,854 Components of medical care costs related to: Current year 5,777 1,044 551 7,372 Prior years (34) (22) (2) (58) Total medical care costs 5,743 1,022 549 7,314 Payments for medical care costs related to: Current year 4,493 783 412 5,688 Prior years 1,161 228 97 1,486 Total paid 5,654 1,011 509 7,174 Change in non-risk and other provider payables (34) — — (34) Medical claims and benefits payable, ending balance $ 1,520 $ 278 $ 162 $ 1,960 Our estimates of medical claims and benefits payable recorded at December 31, 2020, and 2019 developed favorably by approximately $193 million and $58 million as of June 30, 2021, and 2020, respectively. The favorable prior period development recognized in the six months ended June 30, 2021 was primarily due to lower than expected utilization of medical services by our Medicaid members and improved operating performance. Consequently, the ultimate costs recognized in 2021, as claims payments were processed, were lower than our previous estimates in 2020.

Debt

Debt	6 Months Ended
	Jun. 30, 2021
Debt Disclosure [Abstract]
Debt	Debt All long-term debt is held at the parent, which is reported in the Other segment. The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below: June 30, December 31, (In millions) Non-current long-term debt: 4.375% Notes due 2028 $ 800 $ 800 5.375% Notes due 2022 700 700 3.875% Notes due 2030 650 650 Deferred debt issuance costs (21) (23) Total $ 2,129 $ 2,127 Credit Agreement We are party to a credit agreement (“Credit Agreement”) which includes a revolving credit facility (“Credit Facility”) of $1.0 billion, among other provisions. The Credit Agreement has a term of five years, and all amounts outstanding will be due and payable on June 8, 2025. Borrowings under the Credit Agreement bear interest based, at our election, on a base rate or other defined rate, plus in each case, the applicable margin. In addition to interest payable on the principal amount of indebtedness outstanding from time to time under the Credit Agreement, we are required to pay a quarterly commitment fee. The Credit Agreement contains customary non-financial and financial covenants. As of June 30, 2021, we were in compliance with all financial and non-financial covenants under the Credit Agreement and other long-term debt. As of June 30, 2021, no amounts were outstanding under the Credit Facility. High-Yield Senior Notes Our high-yield senior notes are described below. Each of these notes are senior unsecured obligations of Molina Healthcare, and rank equally in right of payment with all existing and future senior debt, and senior to all existing and future subordinated debt of Molina Healthcare. In addition, each of the notes contain customary non-financial covenants and change of control provisions. The indentures governing the high-yield senior notes contain cross-default provisions that are triggered upon default by us or any of our subsidiaries on any indebtedness in excess of the amount specified in the applicable indenture. 4.375% Notes due 2028. We had $800 million aggregate principal amount of senior notes (the “4.375% Notes”) outstanding as of June 30, 2021, which are due June 15, 2028, unless earlier redeemed. Interest, at a rate of 4.375% per annum, is payable semiannually in arrears on June 15 and December 15. 5.375% Notes due 2022. We had $700 million aggregate principal amount of senior notes (the “5.375% Notes”) outstanding as of June 30, 2021, which are due November 15, 2022, unless earlier redeemed. Interest, at a rate of 5.375% per annum, is payable semiannually in arrears on May 15 and November 15. 3.875% Notes due 2030. We had $650 million aggregate principal amount of senior notes (the “3.875% Notes”) outstanding as of June 30, 2021, which are due November 15, 2030, unless earlier redeemed. Interest, at a rate of 3.875% per annum, is payable semiannually in arrears on May 15 and November 15.

Stockholders' Equity

Stockholders' Equity	6 Months Ended
	Jun. 30, 2021
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity In September 2020, our board of directors authorized the purchase of up to $500 million, in the aggregate, of our common stock. This program is funded with cash on hand and extends through December 31, 2021. The exact timing and amount of any repurchase is determined by management based on market conditions and share price, in addition to other factors, and subject to the restrictions relating to volume, price, and timing under applicable law. Under this program, pursuant to a Rule 10b5-1 trading plan, we purchased approximately 577,000 shares for $122 million in January and February 2021 (average cost of $211.65). In the first quarter of 2021, we also paid $6 million to settle shares purchased in late December 2020.

Segments

Segments	6 Months Ended
	Jun. 30, 2021
Segment Reporting [Abstract]
Segments	Segments In the first quarter of 2021, we realigned our reportable operating segments to reflect recent changes in our internal operating and reporting structure, which is now organized by government program. The revised reporting structure reflects the reporting and review process used by our chief executive officer (who is our chief operating decision maker) to assess performance and allocate resources, and is consistent with how we currently manage the business and view the markets we serve. These reportable segments consist of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. The Medicaid, Medicare, and Marketplace segments represent the government-funded or sponsored programs under which we offer managed healthcare services. The Other segment, which is insignificant to our consolidated results of operations, includes certain corporate amounts not associated with or allocated to the Medicaid, Medicare, or Marketplace segments. Additionally, the Other segment includes service revenues and service costs associated with the long-term services and supports consultative services we now provide in Wisconsin, as a result of the Magellan Complete Care acquisition on December 31, 2020. The key metrics used to assess the performance of our Medicaid, Medicare, and Marketplace segments are premium revenue, medical margin and MCR. MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying medical margin, or the amount earned by the Medicaid, Medicare, and Marketplace segments after medical costs are deducted from premium revenue, represents the most important measure of earnings reviewed by management, and is used by our chief executive officer to review results, assess performance, and allocate resources. The key metric used to assess the performance of our Other segment is service margin. The service margin is equal to service revenue minus cost of service revenue. We do not report total assets by segment because this is not a metric used to assess segment performance or allocate resources. For all tables presented below, the prior period disclosures have been recast to conform to the current period segment presentation. The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented. Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (In millions) Total revenue: Medicaid $ 5,209 $ 3,611 $ 10,229 $ 7,128 Medicare 822 634 1,627 1,273 Marketplace 751 373 1,431 766 Other 18 — 35 — Total $ 6,800 $ 4,618 $ 13,322 $ 9,167 The following table presents goodwill and intangibles assets, net by segment. For the Magellan Complete Care acquisition completed on December 31, 2020, the total purchase price was preliminarily allocated to tangible and intangible assets acquired, and liabilities assumed, based on their fair values as of the acquisition date. We expect to complete the final determination of the purchase price allocation no later than December 31, 2021, which may result in adjustments to the related goodwill and intangible assets, net. June 30, December 31, 2021 2020 (In millions) Goodwill: Medicaid $ 390 $ 378 Medicare 247 247 Other 67 67 Intangibles assets, net: Medicaid 143 157 Medicare 68 76 Other 14 16 Total $ 929 $ 941 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (In millions) Margin: Medicaid $ 551 $ 553 $ 1,155 $ 918 Medicare 101 125 178 242 Marketplace 112 96 263 202 Other 3 — 7 — Total margin 767 774 1,603 1,362 Add: other operating revenues (1) 199 246 398 491 Less: other operating expenses (2) (693) (596) (1,393) (1,155) Operating income 273 424 608 698 Other expenses, net 30 29 60 50 Income before income tax expense $ 243 $ 395 $ 548 $ 648 ______________________ (1) Other operating revenues include premium tax revenue, health insurer fees reimbursed, investment income, and other revenue. (2) Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fees, depreciation and amortization, and other operating expenses.

Commitments and Contingencies

Commitments and Contingencies	6 Months Ended
	Jun. 30, 2021
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies COVID-19 Pandemic We continue to monitor and assess the estimated operating and financial impact of the COVID-19 pandemic, and as it evolves, we continue to process, assemble, and assess member utilization information. We believe that our cash resources, borrowing capacity available under the Credit Agreement, and cash flow generated from operations will continue to be sufficient to withstand the financial impact of the pandemic, and will enable us to continue to support our operations, regulatory requirements, debt repayment obligations, and capital expenditures for the foreseeable future. Legal Proceedings The healthcare industry is subject to numerous laws and regulations of federal, state, and local governments. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. The consequences associated with violations of these laws and regulations include significant fines and penalties, exclusion from participating in publicly funded programs, and the repayment of previously collected revenues. We are involved in legal actions in the ordinary course of business including, but not limited to, various employment claims, vendor disputes and provider claims. Some of these legal actions seek monetary damages, including claims for punitive damages, which may not be covered by insurance. We review legal matters and update our estimates of reasonably possible losses and related disclosures, as necessary. We have accrued liabilities for legal matters for which we deem the loss to be both probable and reasonably estimable. These liability estimates could change as a result of further developments of the matters. The outcome of legal actions is inherently uncertain. An adverse determination in one or more of these pending matters could have an adverse effect on our consolidated financial position, results of operations, or cash flows. Kentucky RFP . On September 4, 2020, Anthem Kentucky Managed Care Plan, Inc. brought an action in Franklin County Circuit Court against the Kentucky Finance and Administration Cabinet, the Kentucky Cabinet for Health and Family Services, and all of the five winning bidder health plans, including Molina Healthcare of Kentucky, Inc., Civil Action No. 20-CI-00719. On October 23, 2020, the Court issued a temporary injunction directing that open enrollment for 2021 proceed with six health plans, including both Molina Healthcare of Kentucky and Anthem. The new Medicaid contracts commenced on January 1, 2021. On April 28, 2021, the Court issued its preliminary Opinion and Order, which Opinion and Order the Court finalized on June 16, 2021. Under the final Order, which the Court indicated is immediately appealable by the parties, the Court, among other things, upheld the validity of the RFP award to Molina, and also upheld the validity of Molina’s acquisition of the assets of Passport in September 2020. Due to various perceived scoring irregularities, however, the Court ordered a new RFP, with the status quo of six health plans serving Kentucky Medicaid members to continue in the interim. On July 15-16, 2021, each of United, Molina, Humana, and Aetna filed notices of appeal. On July 23, 2021, both the Kentucky Finance and Administration Cabinet and the Kentucky Cabinet for Health and Family Services filed notices of cross appeal, and on July 26, 2021, Anthem filed a notice of cross appeal. This matter remains subject to potential additional legal and appellate proceedings, and no assurances can be given regarding the ultimate outcome. Under the Court’s June 16, 2021 final Order, Molina Healthcare of Kentucky will continue to operate for the foreseeable future under its current Medicaid contract and provide care to Kentucky Medicaid members.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	6 Months Ended
	Jun. 30, 2021
Accounting Policies [Abstract]
Consolidation and Interim Financial Information	Consolidation and Interim Financial Information The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the interim periods presented have been included; such adjustments consist of normal recurring adjustments. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the six months ended June 30, 2021 are not necessarily indicative of the results for the entire year ending December 31, 2021. The unaudited consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read or have access to our audited consolidated financial statements for the fiscal year ended December 31, 2020. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2020, audited consolidated financial statements have been omitted. These unaudited consolidated interim financial statements should be read in conjunction with our audited consolidated financial statements for the fiscal year ended December 31, 2020. Reclassifications Consistent with the change in reportable segments described above, certain prior year disclosures in Note 7, “Medical Claims and Benefits Payable,” and Note 10, “Segments,” have been recast to conform to the current year presentation. Certain immaterial amounts presented in the accompanying consolidated statement of cash flows for the six months ended June 30, 2020, have been reclassified to conform to the current year presentation.
Use of Estimates	Use of Estimates The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates. Principal areas requiring the use of estimates include: • The determination of medical claims and benefits payable; • Contractual provisions that may limit revenue recognition based upon the costs incurred or the profits realized under a specific contract; • Quality incentives that allow us to recognize incremental revenue if certain quality standards are met; • Settlements under risk- or savings-sharing programs; • Purchase price allocations relating to business combinations, including the determination of contingent consideration; • The assessment of long-lived and intangible assets, and goodwill for impairment; • The determination of reserves for potential absorption of claims unpaid by insolvent providers; • The determination of reserves for the outcome of litigation; • The determination of valuation allowances for deferred tax assets; and
Cash and Cash Equivalents	Cash and Cash Equivalents Cash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase. The following table reconciles cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.
Receivables	Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made.
Premium Revenue Recognition and Premiums Receivable	Premium Revenue Recognition and Amounts Due Government Agencies Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the Medicaid, Medicare, and Marketplace programs. Premium revenue is generally received based on per member per month (“PMPM”) rates established in advance of the periods covered. These premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. State Medicaid programs and the federal Medicare program periodically adjust premium rates. Certain components of premium revenue are subject to accounting estimates and are described in further detail below, and in our 2020 Annual Report on Form 10-K, Note 2, “Significant Accounting Policies,” under “Contractual Provisions That May Adjust or Limit Revenue or Profit,” and “Quality Incentives.” Contractual Provisions That May Adjust or Limit Revenue or Profit Medicaid Minimum MLR and Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, and is based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. Beginning in 2020, through June 30, 2021, various states enacted temporary risk corridors in response to the reduced demand for medical services stemming from COVID-19, which have resulted in a reduction of our medical margin. In some cases, these risk corridors were retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. Beginning in the second quarter of 2020, we have recognized retroactive risk corridors that we believe to be probable, and where the ultimate premium amount is reasonably estimable. For the three and six months ended June 30, 2021, we recognized approximately $56 million and $166 million, respectively, related to such risk corridors, primarily in the Medicaid segment. It is possible that certain states could increase the level of existing risk corridors, and other states could implement some form of risk corridors in the future. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a result of changes in facts or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows. Marketplace
Concentrations of Credit Risk	Concentrations of Credit Risk Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. Our investments consist primarily of investment-grade debt securities with final maturities of less than 10 years, or less than 10 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the federal government, and the local governments of the states in which our health plan subsidiaries operate.
Income Taxes	Income Taxes The provision for income taxes is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of foreign and state taxes, and nondeductible expenses such as certain compensation and other general and administrative expenses. The effective tax rate may be subject to fluctuations during the year as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including projected pretax earnings, the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers.
Recent Accounting Pronouncements	Recent Accounting Pronouncements Various recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, and the Securities and Exchange Commission (“SEC”) did not

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	6 Months Ended
	Jun. 30, 2021
Accounting Policies [Abstract]
Cash and cash equivalents	The following table reconciles cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets. June 30, 2021 2020 (In millions) Cash and cash equivalents $ 4,608 $ 3,303 Restricted cash and cash equivalents 68 63 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,676 $ 3,366
Restricted cash and cash equivalents	The following table reconciles cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets. June 30, 2021 2020 (In millions) Cash and cash equivalents $ 4,608 $ 3,303 Restricted cash and cash equivalents 68 63 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,676 $ 3,366
Schedule of receivables	June 30, December 31, (In millions) Government receivables $ 1,388 $ 969 Pharmacy rebate receivables 216 178 Health insurer fee reimbursement receivables 24 104 Other 229 255 Magellan Complete Care acquisition opening balance — 166 Total $ 1,857 $ 1,672
Amounts due to government agencies	Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies,” in the accompanying consolidated balance sheets. Categorized by segment, such amounts due government agencies included the following: June 30, December 31, (In millions) Medicaid: Minimum MLR and profit sharing $ 774 $ 513 Other 208 76 Medicare: Risk adjustment and Part D risk sharing 88 45 Minimum MLR and profit sharing 136 62 Other 33 30 Marketplace: Risk adjustment 719 326 Minimum MLR 52 37 Other 62 21 Magellan Complete Care acquisition opening balance — 143 Total amounts due government agencies $ 2,072 $ 1,253

Net Income per Share (Tables)

Net Income per Share (Tables)	6 Months Ended
	Jun. 30, 2021
Earnings Per Share [Abstract]
Summary of denominators for the computation of basic and diluted earnings per share	The following table sets forth the calculation of net income per share: Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (In millions, except net income per share) Numerator: Net income $ 185 $ 276 $ 413 $ 454 Denominator: Shares outstanding at the beginning of the period 57.7 58.6 58.0 61.9 Weighted-average number of shares issued: Stock purchases — — (0.5) (2.5) Stock-based compensation — — 0.2 — Denominator for basic net income per share 57.7 58.6 57.7 59.4 Effect of dilutive securities: (1) Stock-based compensation 0.7 0.8 0.8 0.8 Denominator for diluted net income per share 58.4 59.4 58.5 60.2 Net income per share - Basic (2) $ 3.20 $ 4.72 $ 7.14 $ 7.65 Net income per share - Diluted (2) $ 3.16 $ 4.65 $ 7.05 $ 7.54 ______________________________ (1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method. (2) Source data for calculations in thousands.

Fair Value Measurements (Tables

Fair Value Measurements (Tables)	6 Months Ended
	Jun. 30, 2021
Fair Value Disclosures [Abstract]
Fair value of assets measured on recurring basis	Our financial instruments measured at fair value on a recurring basis at June 30, 2021, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 1,393 $ — $ 1,393 $ — Mortgage-backed securities 548 — 548 — Asset-backed securities 176 — 176 — Municipal securities 75 — 75 — U.S. Treasury notes 26 — 26 — Other 23 — 23 — Total assets $ 2,241 $ — $ 2,241 $ — Contingent consideration liabilities $ 26 $ — $ — $ 26 Total liabilities $ 26 $ — $ — $ 26 Our financial instruments measured at fair value on a recurring basis at December 31, 2020, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 1,256 $ — $ 1,256 $ — Mortgage-backed securities 392 — 392 — Asset-backed securities 132 — 132 — Municipal securities 68 — 68 — U.S. Treasury notes 27 — 27 — Total assets $ 1,875 $ — $ 1,875 $ — Contingent consideration liabilities $ 46 $ — $ — $ 46 Total liabilities $ 46 $ — $ — $ 46
Fair value measurements of senior notes	June 30, 2021 December 31, 2020 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes $ 790 $ 835 $ 789 $ 843 5.375% Notes 698 733 697 742 3.875% Notes 641 678 641 691 Total $ 2,129 $ 2,246 $ 2,127 $ 2,276

Investments (Tables)

Investments (Tables)	6 Months Ended
	Jun. 30, 2021
Investments, Debt and Equity Securities [Abstract]
Investments	The following tables summarize our investments as of the dates indicated: June 30, 2021 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,367 $ 26 $ — $ 1,393 Mortgage-backed securities 542 7 1 548 Asset-backed securities 174 2 — 176 Municipal securities 74 1 — 75 U.S. Treasury notes 26 — — 26 Other 23 — — 23 Total $ 2,206 $ 36 $ 1 $ 2,241 December 31, 2020 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,220 $ 36 $ — $ 1,256 Mortgage-backed securities 383 10 1 392 Asset-backed securities 130 2 — 132 Municipal securities 66 2 — 68 U.S. Treasury notes 27 — — 27 Total $ 1,826 $ 50 $ 1 $ 1,875
Contractual maturities of investments	The contractual maturities of our available-for-sale investments as of June 30, 2021 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 312 $ 314 Due after one year through five years 1,200 1,225 Due after five years through ten years 264 267 Due after ten years 430 435 Total $ 2,206 $ 2,241
Available-for-sale investments	The following table summarizes those available-for-sale investments that have been in a continuous loss position for less than 12 months. No investments have been in a continuous loss position for 12 months or more as of June 30, 2021, and December 31, 2020. June 30, 2021 December 31, 2020 Estimated Unrealized Total Estimated Unrealized Total (Dollars in millions) Mortgage-backed securities $ 154 $ 1 62 $ 77 $ 1 21 Total $ 154 $ 1 62 $ 77 $ 1 21

Medical Claims and Benefits P_2

Medical Claims and Benefits Payable (Tables)	6 Months Ended
	Jun. 30, 2021
Other Liabilities Disclosure [Abstract]
Schedule of liability for unpaid claims and claims adjustment expense	The following table provides the details of our medical claims and benefits payable as of the dates indicated: June 30, December 31, (In millions) Fee-for-service claims incurred but not paid (“IBNP”) $ 2,120 $ 1,647 Pharmacy payable 221 157 Capitation payable 89 70 Other 512 528 Magellan Complete Care acquisition opening balance — 294 Total $ 2,942 $ 2,696
Components of the change in medical claims and benefits payable	The following table presents the components of the change in our medical claims and benefits payable for the periods indicated, with the prior period recast to conform to the current year presentation. The amounts presented for “Components of medical care costs related to: Prior years” represent decreases in medical care costs resulting from actual medical care costs being less than we previously estimated in the prior year. Six Months Ended June 30, 2021 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,129 $ 392 $ 175 $ 2,696 Components of medical care costs related to: Current year 8,869 1,459 1,158 11,486 Prior years (150) (24) (19) (193) Total medical care costs 8,719 1,435 1,139 11,293 Payments for medical care costs related to: Current year 7,043 1,111 869 9,023 Prior years 1,491 330 128 1,949 Total paid 8,534 1,441 997 10,972 Change in acquired balances (19) (7) — (26) Change in non-risk and other provider payables (48) (1) — (49) Medical claims and benefits payable, ending balance $ 2,247 $ 378 $ 317 $ 2,942 Six Months Ended June 30, 2020 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 1,465 $ 267 $ 122 $ 1,854 Components of medical care costs related to: Current year 5,777 1,044 551 7,372 Prior years (34) (22) (2) (58) Total medical care costs 5,743 1,022 549 7,314 Payments for medical care costs related to: Current year 4,493 783 412 5,688 Prior years 1,161 228 97 1,486 Total paid 5,654 1,011 509 7,174 Change in non-risk and other provider payables (34) — — (34) Medical claims and benefits payable, ending balance $ 1,520 $ 278 $ 162 $ 1,960

Debt (Tables)

Debt (Tables)	6 Months Ended
	Jun. 30, 2021
Debt Disclosure [Abstract]
Long term debt	The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below: June 30, December 31, (In millions) Non-current long-term debt: 4.375% Notes due 2028 $ 800 $ 800 5.375% Notes due 2022 700 700 3.875% Notes due 2030 650 650 Deferred debt issuance costs (21) (23) Total $ 2,129 $ 2,127

Segments (Tables)

Segments (Tables)	6 Months Ended
	Jun. 30, 2021
Segment Reporting [Abstract]
Operating segment information	The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented. Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (In millions) Total revenue: Medicaid $ 5,209 $ 3,611 $ 10,229 $ 7,128 Medicare 822 634 1,627 1,273 Marketplace 751 373 1,431 766 Other 18 — 35 — Total $ 6,800 $ 4,618 $ 13,322 $ 9,167 The following table presents goodwill and intangibles assets, net by segment. For the Magellan Complete Care acquisition completed on December 31, 2020, the total purchase price was preliminarily allocated to tangible and intangible assets acquired, and liabilities assumed, based on their fair values as of the acquisition date. We expect to complete the final determination of the purchase price allocation no later than December 31, 2021, which may result in adjustments to the related goodwill and intangible assets, net. June 30, December 31, 2021 2020 (In millions) Goodwill: Medicaid $ 390 $ 378 Medicare 247 247 Other 67 67 Intangibles assets, net: Medicaid 143 157 Medicare 68 76 Other 14 16 Total $ 929 $ 941 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended June 30, Six Months Ended June 30, 2021 2020 2021 2020 (In millions) Margin: Medicaid $ 551 $ 553 $ 1,155 $ 918 Medicare 101 125 178 242 Marketplace 112 96 263 202 Other 3 — 7 — Total margin 767 774 1,603 1,362 Add: other operating revenues (1) 199 246 398 491 Less: other operating expenses (2) (693) (596) (1,393) (1,155) Operating income 273 424 608 698 Other expenses, net 30 29 60 50 Income before income tax expense $ 243 $ 395 $ 548 $ 648 ______________________ (1) Other operating revenues include premium tax revenue, health insurer fees reimbursed, investment income, and other revenue. (2) Other operating expenses include general and administrative expenses, premium tax expenses, health insurer fees, depreciation and amortization, and other operating expenses.

Organization and Basis of Pre_2

Organization and Basis of Presentation (Details) member in Thousands, $ in Millions	Apr. 22, 2021USD ($)	Sep. 30, 2020USD ($)	Jun. 30, 2021USD ($)positionmember	Jun. 30, 2020USD ($)	Jun. 30, 2021USD ($)positionmember	Jun. 30, 2020USD ($)	Dec. 31, 2020USD ($)member
Segment Reporting Information [Line Items]
Number of states with programs | position			18		18
Premium revenue			$ 6,583	$ 4,372	$ 12,889	$ 8,676
Cigna Corporation's Texas Medicaid and Medicare-Medicaid Plan
Segment Reporting Information [Line Items]
Premium revenue							$ 1,000
Cigna Corporation's Texas Medicaid and Medicare-Medicaid Plan | Hidalgo, Tarrant and Northeast Service Areas
Segment Reporting Information [Line Items]
Number of members covered | member							48
Cigna Corporation's Texas Medicaid and Medicare-Medicaid Plan | Hidalgo Service Area
Segment Reporting Information [Line Items]
Number of members covered | member							2
Cigna Corporation's Texas Medicaid and Medicare-Medicaid Plan
Segment Reporting Information [Line Items]
Total Purchase price	$ 60
Affinity health plan
Segment Reporting Information [Line Items]
Net cash paid in business combinations		$ 380
Health Plans
Segment Reporting Information [Line Items]
Number of members eligible for the health care programs, approximately | member			4,700		4,700
Minimum | Health Plans
Segment Reporting Information [Line Items]
Contract term					3 years
Maximum | Health Plans
Segment Reporting Information [Line Items]
Contract term					5 years

Significant Accounting Polici_4

Significant Accounting Policies - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020	Jun. 30, 2020	Dec. 31, 2019
Accounting Policies [Abstract]
Cash and cash equivalents	$ 4,608	$ 4,154	$ 3,303
Restricted cash and cash equivalents	68		63
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$ 4,676	$ 4,223	$ 3,366	$ 2,508

Significant Accounting Polici_5

Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	$ 1,857	$ 1,672
Government receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	1,388	969
Pharmacy rebate receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	216	178
Health insurer fee reimbursement receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	24	104
Other
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	229	255
Magellan Complete Care acquisition opening balance
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	$ 0	$ 166

Significant Accounting Polici_6

Significant Accounting Policies - Amounts Due To Government Agencies (Details) - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020
Medicaid:
Minimum MLR and profit sharing	$ 774	$ 513
Other	208	76
Medicare:
Risk adjustment and Part D risk sharing	88	45
Minimum MLR and profit sharing	136	62
Other	33	30
Marketplace:
Risk adjustment	719	326
Minimum MLR	52	37
Other	62	21
Magellan Complete Care acquisition opening balance	0	143
Medical Premium Liability Due To Agency	$ 2,072	$ 1,253

Significant Accounting Polici_7

Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions	3 Months Ended	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2021	Dec. 31, 2020	Jun. 30, 2020
Schedule of Premium Revenue by Health Plan Type [Line Items]
Risk adjustment payable	$ 719	$ 719	$ 326
Risk adjustment receivable	40	40	20
Risk adjustment, net payable	679	679	$ 306
Risk adjustment, net payable, current year	414	$ 414
Risk adjustment, net payable, prior year				$ 265
Maturity period (less than)		10 years
Structured Securities
Schedule of Premium Revenue by Health Plan Type [Line Items]
Average maturity period (less than)		10 years
COVID-19
Schedule of Premium Revenue by Health Plan Type [Line Items]
Reduction in premiums	$ 56	$ 166

Net Income per Share (Details)

Net Income per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended				6 Months Ended
	Jun. 30, 2021	Mar. 31, 2021	Jun. 30, 2020	Mar. 31, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020	Dec. 31, 2019
Numerator:
Net income	$ 185	$ 228	$ 276	$ 178	$ 413	$ 454
Denominator:
Shares outstanding at the beginning of the period (in shares)		57.7		58.6			58	61.9
Weighted-average number of shares issued:
Stock purchases (in shares)	0		0		(0.5)	(2.5)
Stock-based compensation (in shares)	0		0		0.2	0
Denominator for basic net income per share (in shares)	57.7		58.6		57.7	59.4
Effect of dilutive securities:
Stock-based compensation (in shares)	0.7		0.8		0.8	0.8
Denominator for diluted net income per share (in shares)	58.4		59.4		58.5	60.2
Net income per share:
Net income per share - Basic (in dollars per share)	$ 3.20		$ 4.72		$ 7.14	$ 7.65
Net income per share - Diluted (in dollars per share)	$ 3.16		$ 4.65		$ 7.05	$ 7.54

Business Combinations - Narrati

Business Combinations - Narrative (Details) - Magellan complete care - USD ($) $ in Millions	Dec. 31, 2020	Jun. 30, 2021
Business Acquisition, Contingent Consideration [Line Items]
Outstanding equity interests	100.00%
Total Purchase price	$ 1,037
Receivables		$ 7
Payable		26
Amounts due government agencies		27
Goodwill		$ 12

Fair Value Measurements - Finan

Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	$ 2,241	$ 1,875
Total assets	2,241	1,875
Contingent consideration liabilities	26	46
Total liabilities	26	46
Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	1,393	1,256
Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	548	392
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	176	132
Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	75	68
U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	26	27
Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	23
(Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities	0	0
Total liabilities	0	0
(Level 1) | Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) | Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) | U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) | Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0
(Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	2,241	1,875
Contingent consideration liabilities	0	0
Total liabilities	0	0
(Level 2) | Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	1,393	1,256
(Level 2) | Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	548	392
(Level 2) | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	176	132
(Level 2) | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	75	68
(Level 2) | U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	26	27
(Level 2) | Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	23
(Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities		46
Total liabilities	26	46
(Level 3) | Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) | Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) | U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	$ 0
(Level 3) | Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	$ 0

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2021	Dec. 31, 2020
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Recognized loss	$ 3
Contingent consideration liabilities	26	$ 46
(Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration liabilities		$ 46
Passport Health Plan, Inc.
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Paid to seller	23
Passport Health Plan, Inc. | (Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration liabilities	$ 26

Fair Value Measurements - Long-

Fair Value Measurements - Long-Term Debt (Details) - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020
Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 2,129	$ 2,127
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 2,246	2,276
Senior notes | 4.375% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	4.375%
Senior notes | 4.375% Notes | Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 790	789
Senior notes | 4.375% Notes | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 835	843
Senior notes | 5.375% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	5.375%
Senior notes | 5.375% Notes | Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 698	697
Senior notes | 5.375% Notes | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 733	742
Senior notes | 3.875% Notes
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	3.875%
Senior notes | 3.875% Notes | Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 641	641
Senior notes | 3.875% Notes | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 678	$ 691

Investments - Summary of Invest

Investments - Summary of Investments (Details) - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 2,206	$ 1,826
Gross unrealized gains	36	50
Gross unrealized losses	1	1
Estimated Fair Value	2,241	1,875
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	1,367	1,220
Gross unrealized gains	26	36
Gross unrealized losses	0	0
Estimated Fair Value	1,393	1,256
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	542	383
Gross unrealized gains	7	10
Gross unrealized losses	1	1
Estimated Fair Value	548	392
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	174	130
Gross unrealized gains	2	2
Gross unrealized losses	0	0
Estimated Fair Value	176	132
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	74	66
Gross unrealized gains	1	2
Gross unrealized losses	0	0
Estimated Fair Value	75	68
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	26	27
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Estimated Fair Value	26	$ 27
Other
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	23
Gross unrealized gains	0
Gross unrealized losses	0
Estimated Fair Value	$ 23

Investments - Contractual Matur

Investments - Contractual Maturities of Available-for-Sale Investments (Details) $ in Millions	Jun. 30, 2021USD ($)
Amortized Cost
Due in one year or less	$ 312
Due after one year through five years	1,200
Due after five years through ten years	264
Due after ten years	430
Amortized Cost	2,206
Estimated Fair Value
Due in one year or less	314
Due after one year through five years	1,225
Due after five years through ten years	267
Due after ten years	435
Estimated Fair Value	$ 2,241

Investments - Narrative (Detail

Investments - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020
Investments, Debt and Equity Securities [Abstract]
Gross realized investment gains	$ 0	$ 1	$ 0	$ 6
Gross realized investment losses	0	$ 0	0	$ 0
Debt securities held to maturity	145		145
Amortized Cost, Due in one year or less	137		137
Amortized Cost, Due one year through five years	$ 8		$ 8

Investments - Available-for-Sal

Investments - Available-for-Sale Investments (Details) $ in Millions	Jun. 30, 2021USD ($)position	Dec. 31, 2020USD ($)position
Debt Securities, Available-for-sale [Line Items]
Estimated Fair Value	$ 154	$ 77
Unrealized Losses	$ 1	$ 1
Total Number of Positions | position	62	21
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Estimated Fair Value	$ 154	$ 77
Unrealized Losses	$ 1	$ 1
Total Number of Positions | position	62	21

Medical Claims and Benefits P_3

Medical Claims and Benefits Payable - Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020	Jun. 30, 2020	Dec. 31, 2019
Liability for Claims and Claims Adjustment Expense [Line Items]
Fee-for-service claims incurred but not paid (“IBNP”)	$ 2,120	$ 1,647
Pharmacy payable	221	157
Capitation payable	89	70
Other	512	528
Total	2,942	2,696	$ 1,960	$ 1,854
Magellan complete care
Liability for Claims and Claims Adjustment Expense [Line Items]
Total	$ 0	$ 294

Medical Claims and Benefits P_4

Medical Claims and Benefits Payable - Narrative (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Other Liabilities Disclosure [Abstract]
Non-risk provider payables	$ 185		$ 235
Prior period claims, favorable development	$ (193)	$ (58)

Medical Claims and Benefits P_5

Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Insurance Claims
Medical claims and benefits payable, beginning balance	$ 2,696	$ 1,854
Components of medical care costs related to:
Current year	11,486	7,372
Prior years	(193)	(58)
Total medical care costs	11,293	7,314
Payments for medical care costs related to:
Current year	9,023	5,688
Prior years	1,949	1,486
Total paid	10,972	7,174
Change in acquired balances	(26)
Change in non-risk and other provider payables	(49)	(34)
Medical claims and benefits payable, ending balance	2,942	1,960
Medicaid
Insurance Claims
Medical claims and benefits payable, beginning balance	2,129	1,465
Components of medical care costs related to:
Current year	8,869	5,777
Prior years	(150)	(34)
Total medical care costs	8,719	5,743
Payments for medical care costs related to:
Current year	7,043	4,493
Prior years	1,491	1,161
Total paid	8,534	5,654
Change in acquired balances	(19)
Change in non-risk and other provider payables	(48)	(34)
Medical claims and benefits payable, ending balance	2,247	1,520
Medicare
Insurance Claims
Medical claims and benefits payable, beginning balance	392	267
Components of medical care costs related to:
Current year	1,459	1,044
Prior years	(24)	(22)
Total medical care costs	1,435	1,022
Payments for medical care costs related to:
Current year	1,111	783
Prior years	330	228
Total paid	1,441	1,011
Change in acquired balances	(7)
Change in non-risk and other provider payables	(1)	0
Medical claims and benefits payable, ending balance	378	278
Marketplace
Insurance Claims
Medical claims and benefits payable, beginning balance	175	122
Components of medical care costs related to:
Current year	1,158	551
Prior years	(19)	(2)
Total medical care costs	1,139	549
Payments for medical care costs related to:
Current year	869	412
Prior years	128	97
Total paid	997	509
Change in acquired balances	0
Change in non-risk and other provider payables	0	0
Medical claims and benefits payable, ending balance	$ 317	$ 162

Debt - Schedule of Long-Term De

Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions	Jun. 30, 2021	Dec. 31, 2020
Debt Instrument [Line Items]
Deferred debt issuance costs	$ (21)	$ (23)
Total	$ 2,129	2,127
Senior notes | 4.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.375%
Non-current portion of long-term debt	$ 800	800
Senior notes | 5.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	5.375%
Non-current portion of long-term debt	$ 700	700
Senior notes | 3.875% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Non-current portion of long-term debt	$ 650	$ 650

Debt - Narrative (Details)

Debt - Narrative (Details)	6 Months Ended
	Jun. 30, 2021USD ($)
Line of Credit
Debt Instrument [Line Items]
Debt term	5 years
Line of Credit | Credit facility
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 1,000,000,000
Amount outstanding under letter of credit	$ 0
Senior notes | 4.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.375%
Face amount	$ 800,000,000
Senior notes | 5.375% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	5.375%
Face amount	$ 700,000,000
Senior notes | 3.875% Notes
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Face amount	$ 650,000,000

Stockholders' Equity - Narrativ

Stockholders' Equity - Narrative (Details) - USD ($) $ / shares in Units, shares in Thousands	1 Months Ended		2 Months Ended	3 Months Ended		6 Months Ended
	Feb. 28, 2021	Jan. 31, 2021	Feb. 28, 2021	Mar. 31, 2021	Mar. 31, 2020	Jun. 30, 2021	Jun. 30, 2020	Sep. 30, 2020
Class of Stock [Line Items]
Repurchased of common stock				$ 122,000,000	$ 446,000,000
Payments to settle shares purchased						$ 128,000,000	$ 453,000,000
Common Stock
Class of Stock [Line Items]
Common stock authorized								$ 500,000,000
Repurchased of common stock (in shares)		577		1,000	3,000
Repurchased of common stock	$ 122,000,000
Average cost (USD per share)			$ 211.65
Payments to settle shares purchased				$ 6,000,000

Segments - Reconciliation of Gr

Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions	3 Months Ended		6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020	Jun. 30, 2021	Jun. 30, 2020	Dec. 31, 2020
Segment Reporting Information [Line Items]
Total revenue	$ 6,800	$ 4,618	$ 13,322	$ 9,167
Total	929		929		$ 941
Less: other operating expenses	(6,527)	(4,194)	(12,714)	(8,469)
Operating income	273	424	608	698
Other expenses, net	30	29	60	50
Income before income tax expense	243	395	548	648
Medicaid
Segment Reporting Information [Line Items]
Total revenue	5,209	3,611	10,229	7,128
Goodwill	390		390		378
Intangible assets, net	143		143		157
Medicare
Segment Reporting Information [Line Items]
Total revenue	822	634	1,627	1,273
Goodwill	247		247		247
Intangible assets, net	68		68		76
Marketplace
Segment Reporting Information [Line Items]
Total revenue	751	373	1,431	766
Other
Segment Reporting Information [Line Items]
Total revenue	18	0	35	0
Goodwill	67		67		67
Intangible assets, net	14		14		$ 16
Operating segments
Segment Reporting Information [Line Items]
Total margin	767	774	1,603	1,362
Operating segments | Medicaid
Segment Reporting Information [Line Items]
Total margin	551	553	1,155	918
Operating segments | Medicare
Segment Reporting Information [Line Items]
Total margin	101	125	178	242
Operating segments | Marketplace
Segment Reporting Information [Line Items]
Total margin	112	96	263	202
Operating segments | Other
Segment Reporting Information [Line Items]
Total margin	3	0	7	0
Other operating
Segment Reporting Information [Line Items]
Total revenue	199	246	398	491
Less: other operating expenses	$ (693)	$ (596)	$ (1,393)	$ (1,155)