Molina Healthcare (MOH) 10-Q 27 Oct 22 2022 Q3 Quarterly report Financial data

Cover Page

Cover Page - shares shares in Thousands	9 Months Ended
	Sep. 30, 2022	Oct. 21, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Sep. 30, 2022
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		58,400
Entity Central Index Key	0001179929
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q3
Amendment Flag	false

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Revenue:
Premium revenue	$ 7,636	$ 6,800	$ 22,966	$ 19,689
Premium tax revenue	223	204	646	576
Investment income	49	20	82	39
Other revenue	19	16	57	58
Total revenue	7,927	7,040	23,751	20,362
Operating expenses:
Medical care costs	6,748	6,049	20,183	17,342
General and administrative expenses	560	532	1,682	1,489
Premium tax expenses	223	204	646	576
Depreciation and amortization	45	32	129	96
Other	16	2	43	30
Total operating expenses	7,592	6,819	22,683	19,533
Operating income	335	221	1,068	829
Other expenses, net:
Interest expense	28	30	83	90
Total other expenses, net	28	30	83	90
Income before income tax expense	307	191	985	739
Income tax expense	77	48	249	183
Net income	$ 230	$ 143	$ 736	$ 556
Net income per share:
Net income per share - Basic (in dollars per share)	$ 4	$ 2.49	$ 12.74	$ 9.63
Net income per share - Diluted (in dollars per share)	$ 3.95	$ 2.46	$ 12.58	$ 9.51

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 230	$ 143	$ 736	$ 556
Other comprehensive loss:
Unrealized investment loss	(75)	(13)	(237)	(27)
Less: effect of income taxes	(18)	(4)	(57)	(7)
Other comprehensive loss, net of tax	(57)	(9)	(180)	(20)
Comprehensive income	$ 173	$ 134	$ 556	$ 536

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 4,242	$ 4,438
Investments	3,639	3,202
Receivables	2,220	2,177
Prepaid expenses and other current assets	391	247
Total current assets	10,492	10,064
Property, equipment, and capitalized software, net	412	396
Goodwill, and intangible assets, net	1,263	1,252
Restricted investments	242	212
Deferred income taxes	198	106
Other assets	186	179
Total assets	12,793	12,209
Current liabilities:
Medical claims and benefits payable	3,622	3,363
Amounts due government agencies	2,139	2,472
Accounts payable, accrued liabilities and other	818	842
Deferred revenue	663	370
Total current liabilities	7,242	7,047
Long-term debt	2,175	2,173
Finance lease liabilities	217	219
Other long-term liabilities	118	140
Total liabilities	9,752	9,579
Stockholders’ equity:
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 58 million shares at September 30, 2022 and December 31, 2021	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	289	236
Accumulated other comprehensive loss	(185)	(5)
Retained earnings	2,937	2,399
Total stockholders’ equity	3,041	2,630
Total liabilities and stockholders’ equity	$ 12,793	$ 12,209

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Sep. 30, 2022	Dec. 31, 2021
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	58,000,000
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 Thousands, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Retained Earnings
Beginning balance (in shares) at Dec. 31, 2020		59,000
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)		(1,000)
Common stock purchases	(122)		(2)		(120)
Other comprehensive loss, net	(11)			(11)
Share-based compensation	(27)		(27)
Ending balance (in shares) at Mar. 31, 2021		58,000
Ending balance at Mar. 31, 2021	2,164	$ 0	170	26	1,968
Beginning balance (in shares) at Dec. 31, 2020		59,000
Beginning balance at Dec. 31, 2020	2,096	$ 0	199	37	1,860
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	556
Other comprehensive loss, net	(20)
Ending balance (in shares) at Sep. 30, 2021		58,000
Ending balance at Sep. 30, 2021	2,518	$ 0	205	17	2,296
Beginning balance (in shares) at Mar. 31, 2021		58,000
Beginning balance at Mar. 31, 2021	2,164	$ 0	170	26	1,968
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	185				185
Share-based compensation	21		21
Ending balance (in shares) at Jun. 30, 2021		58,000
Ending balance at Jun. 30, 2021	2,370	$ 0	191	26	2,153
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	143				143
Other comprehensive loss, net	(9)			(9)
Share-based compensation	14		14
Ending balance (in shares) at Sep. 30, 2021		58,000
Ending balance at Sep. 30, 2021	2,518	$ 0	205	17	2,296
Beginning balance (in shares) at Dec. 31, 2021		58,000
Beginning balance at Dec. 31, 2021	2,630	$ 0	236	(5)	2,399
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	258				258
Other comprehensive loss, net	(76)			(76)
Share-based compensation (in shares)		1,000
Share-based compensation	(18)		(18)
Ending balance (in shares) at Mar. 31, 2022		59,000
Ending balance at Mar. 31, 2022	2,794	$ 0	218	(81)	2,657
Beginning balance (in shares) at Dec. 31, 2021		58,000
Beginning balance at Dec. 31, 2021	2,630	$ 0	236	(5)	2,399
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	736
Other comprehensive loss, net	(180)
Ending balance (in shares) at Sep. 30, 2022		58,000
Ending balance at Sep. 30, 2022	3,041	$ 0	289	(185)	2,937
Beginning balance (in shares) at Mar. 31, 2022		59,000
Beginning balance at Mar. 31, 2022	2,794	$ 0	218	(81)	2,657
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	248				248
Common stock purchases (in shares)		(658)
Common stock purchases	(200)		(2)		(198)
Other comprehensive loss, net	(47)			(47)
Share-based compensation	35		35
Ending balance (in shares) at Jun. 30, 2022		58,000
Ending balance at Jun. 30, 2022	2,830	$ 0	251	(128)	2,707
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	230				230
Other comprehensive loss, net	(57)			(57)
Share-based compensation (in shares)		0
Share-based compensation	38		38
Ending balance (in shares) at Sep. 30, 2022		58,000
Ending balance at Sep. 30, 2022	$ 3,041	$ 0	$ 289	$ (185)	$ 2,937

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Operating activities:
Net income	$ 736	$ 556
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	129	96
Deferred income taxes	(35)	(8)
Share-based compensation	80	49
Other, net	(3)	9
Changes in operating assets and liabilities:
Receivables	(15)	(247)
Prepaid expenses and other current assets	(110)	(43)
Medical claims and benefits payable	251	522
Amounts due government agencies	(360)	810
Accounts payable, accrued liabilities and other	(40)	129
Deferred revenue	293	(374)
Income taxes	59	23
Net cash provided by operating activities	985	1,522
Investing activities:
Purchases of investments	(1,764)	(2,018)
Proceeds from sales and maturities of investments	1,082	965
Net cash paid in business combinations	(134)	0
Purchases of property, equipment and capitalized software	(81)	(56)
Other, net	(41)	3
Net cash used in investing activities	(938)	(1,106)
Financing activities:
Common stock purchases	(200)	(128)
Common stock withheld to settle employee tax obligations	(53)	(52)
Contingent consideration liabilities settled	(20)	(20)
Other, net	15	(4)
Net cash used in financing activities	(258)	(204)
Net (decrease) increase in cash, cash equivalents, and restricted cash and cash equivalents	(211)	212
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	4,506	4,223
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$ 4,295	$ 4,435

Organization and Basis of Prese

Organization and Basis of Presentation	9 Months Ended
	Sep. 30, 2022
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”). We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve. As of September 30, 2022, we served approximately 5.2 million members eligible for government-sponsored healthcare programs, located across 19 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 New York Acquisition—Medicaid. On October 1, 2022, we closed on our acquisition of the Medicaid Managed Long Term Care business of AgeWell New York. See Note 4, “Business Combinations,” for further information. Nebraska Procurement—Medicaid. In September 2022, we announced that our Nebraska health plan had been selected by the Nebraska Department of Health and Human Services (DHHS) to provide health care services to Nebraskans under the state’s Medicaid managed care program. The new five-year contract is expected to begin on January 1, 2024, and may be extended for an additional two-years. Iowa Procurement—Medicaid. In August 2022, we announced that our Iowa health plan had been notified by the Iowa Department of Health and Human Services (HHS) of its intent to award a Medicaid managed care contract pursuant to the Request for Proposal issued by HHS on February 17, 2022. The new four-year contract is expected to begin on July 1, 2023, and may be extended for an additional four years. California Procurement—Medicaid. In August 2022, we announced that our California health plan had been notified by the California Department of Health Care Services of its intent to award a Medi-Cal contract in each of Los Angeles, Riverside, San Bernardino, Sacramento, and San Diego Counties. The five Medi-Cal contracts are expected to commence on January 1, 2024, which enables us to continue serving Medi-Cal members in our existing counties and expand footprint with the addition of the Los Angeles County contract. Mississippi Procurement—Medicaid. In August 2022, we announced that our Mississippi health plan had been notified by the Mississippi Division of Medicaid (DOM) of its intent to award a Medicaid Coordinated Care Contract for its Mississippi Coordinated Access Program and Mississippi Children’s Health Insurance Program pursuant to the Request for Qualifications issued by DOM on December 10, 2021. The four Wisconsin Acquisition — Medicaid and Medicare. On July 13, 2022, we announced a definitive agreement to acquire substantially all the assets of My Choice Wisconsin (“MCW”). The purchase price for the transaction is approximately $150 million, net of expected tax benefits and required regulatory capital, which we intend to fund with cash on hand. The transaction is subject to receipt of applicable federal and state regulatory approvals, and the satisfaction of other customary closing conditions. We currently expect the transaction to close in early 2023. Texas Procurement—Medicaid. In March 2022, the Texas Health and Human Services Commission posted the ABD program (known in Texas as STAR+PLUS) RFP. We submitted our proposal in June 2022 to continue serving STAR+PLUS members, with awards estimated to be announced in the first quarter of 2023, and start of operations in February 2024. Further, in October 2022, the draft RFP was posted for the TANF and CHIP programs (known as the STAR & CHIP programs, and both existing contracts for us), with awards expected in late Q4 2023 or early Q1 2024 and the start of operations in late Q4 2024 or early Q1 2025. Nevada Procurement—Medicaid. Our new contract in Clark and Washoe Counties commenced on January 1, 2022, and offers health coverage to TANF, CHIP and Medicaid Expansion beneficiaries. This new contract is four years with a potential two-year extension. Texas Acquisition—Medicaid and Medicare. On January 1, 2022, we closed on our acquisition of Cigna Corporation’s Texas Medicaid and Medicare-Medicaid Plan (“MMP”) contracts, along with certain operating assets. See Note 4, “Business Combinations,” for further 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, these financial statements reflect all normal recurring adjustments, which are considered necessary for a fair presentation of the results as of the dates and for the interim periods presented. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the nine months ended September 30, 2022 are not necessarily indicative of the results for the entire year ending December 31, 2022. 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, 2021. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2021, 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, 2021. Use of Estimates

Significant Accounting Policies

Significant Accounting Policies	9 Months Ended
	Sep. 30, 2022
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 provides a reconciliation of cash and 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. September 30, 2022 2021 (In millions) Cash and cash equivalents $ 4,242 $ 4,357 Restricted cash and cash equivalents 53 78 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,295 $ 4,435 Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all of 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. September 30, December 31, (In millions) Government receivables $ 1,545 $ 1,566 Pharmacy rebate receivables 290 276 Other 385 335 Total $ 2,220 $ 2,177 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 2021 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, as described below. Consequently, 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. The following table sets forth amounts due government agencies, categorized by program: September 30, December 31, (In millions) Medicaid program: Minimum MLR and profit sharing $ 1,091 $ 1,016 Other 617 263 Medicare program: Minimum MLR and profit sharing 100 101 Risk adjustment and Part D risk sharing 74 89 Other 23 35 Marketplace program: Risk adjustment 179 902 Minimum MLR 4 18 Other 51 48 Total amounts due government agencies $ 2,139 $ 2,472 Medicaid Program 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, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. Beginning in 2020, various states enacted temporary risk corridors in response to the reduced demand for medical services stemming from COVID-1 9 , 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. Since the second quarter of 2020, we have recognized risk corridors that we believe to be probable, and where the ultimate premium amount is reasonably estimable. For the three and nine months ended September 30, 2022, we recognized approximately $34 million and $156 million, respectively, related to such risk corridors, primarily in the Medicaid segment, compared to $17 million and $183 million, respectively, recognized in the three and nine months ended September 30, 2021. The decrease is due to the elimination of several of the COVID-19 risk corridors. It is possible that certain states could change the structure of existing risk corridors, implement new risk corridors in the future or discontinue existing risk corridors. 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 Program 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 September 30, 2022, Marketplace risk adjustment payables amounted to $179 million and related receivables amounted to $94 million, for a net payable of $85 million. As of December 31, 2021, Marketplace risk adjustment payables amounted to $902 million and related receivables amounted to $7 million, for a net payable of $895 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 15 years, or less than 15 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 governments of each state 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 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 have, nor does management expect such pronouncements to have, a significant impact on our present or future consolidated financial statements.

Net Income Per Share

Net Income Per Share	9 Months Ended
	Sep. 30, 2022
Earnings Per Share [Abstract]
Net Income Per Share	Net Income Per Share The following table sets forth the calculation of basic and diluted net income per share: Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 (In millions, except net income per share) Numerator: Net income $ 230 $ 143 $ 736 $ 556 Denominator: Shares outstanding at the beginning of the period 57.6 57.8 57.9 58.0 Weighted-average number of shares issued: Stock-based compensation — — 0.2 0.3 Stock purchases — — (0.3) (0.5) Denominator for basic net income per share 57.6 57.8 57.8 57.8 Effect of dilutive securities: (1) Stock-based compensation 0.7 0.7 0.7 0.7 Denominator for diluted net income per share 58.3 58.5 58.5 58.5 Net income per share - Basic (2) $ 4.00 $ 2.49 $ 12.74 $ 9.63 Net income per share - Diluted (2) $ 3.95 $ 2.46 $ 12.58 $ 9.51 ______________________________ (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	9 Months Ended
	Sep. 30, 2022
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Business Combinations AgeWell. As described in Note 1, “Organization and Basis of Presentation,” we announced this acquisition closed on October 1, 2022. Because the closing date fell on a weekend, the $134 million purchase price was paid on September 30, 2022 and was recorded to prepaid expenses and other assets. Such amounts are reported in investing activities in the accompanying consolidated statements of cash flows. The initial accounting for this transaction is incomplete. Cigna. On January 1, 2022, we closed on our acquisition of Cigna Corporation’s Texas Medicaid and Medicare-Medicaid Plan contracts, along with certain operating assets, for purchase consideration of approximately $60 million. We acquired membership and a provider network with a preliminary fair value of approximately $36 million. We allocated the remaining $24 million of purchase consideration to goodwill, primarily in the Medicaid segment, which relates to future economic benefits arising from expected synergies from the use of our existing infrastructure to support the added membership, and from the assembled workforce. The goodwill is deductible for income tax purposes.

Fair Value Measurements

Fair Value Measurements	9 Months Ended
	Sep. 30, 2022
Fair Value Disclosures [Abstract]
Fair Value Measurements	Fair Value Measurements We 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 2021 Annual Report on Form 10-K, Note 5, “Fair Value Measurements.” 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 nine months ended September 30, 2022 and 2021, we recognized a loss of $4 million and $3 million, respectively, for the increase in the fair value of the contingent consideration liabilities described below. Our financial instruments measured at fair value on a recurring basis at September 30, 2022, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 2,283 $ — $ 2,283 $ — Mortgage-backed securities 743 — 743 — Asset-backed securities 303 — 303 — Municipal securities 148 — 148 — U.S. Treasury notes 116 — 116 — Other 46 — 46 — Total assets $ 3,639 $ — $ 3,639 $ — Contingent consideration liabilities $ 8 $ — $ — $ 8 Total liabilities $ 8 $ — $ — $ 8 Our financial instruments measured at fair value on a recurring basis at December 31, 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 $ 1,833 $ — $ 1,833 $ — Mortgage-backed securities 614 — 614 — Asset-backed securities 247 — 247 — Municipal securities 123 — 123 — U.S. Treasury notes 353 — 353 — Other 32 — 32 — Total assets $ 3,202 $ — $ 3,202 $ — Contingent consideration liabilities $ 47 $ — $ — $ 47 Total liabilities $ 47 $ — $ — $ 47 Contingent Consideration Liabilities Our Level 3 financial instruments at September 30, 2022 are comprised solely of contingent consideration liabilities of $8 million, in connection with our 2020 acquisition of certain assets of Passport Health Plan, Inc., a Medicaid health plan in Kentucky. Such liabilities are recorded at fair value on a recurring basis. In the nine months ended September 30, 2022, the estimated fair value of contingent purchase consideration increased by approximately $4 million, relating to an operating income guarantee. In the nine months ended September 30, 2022, we paid the seller $43 million, of which $23 million was for the remaining half of the consideration due for minimum member enrollment targets and $20 million was for the first payment of the consideration due for the operating income guarantee. For the amounts paid in the nine months ended September 30, 2022, $20 million has been presented in “Financing activities” in the accompanying consolidated statements of cash flows, with the balance reflected in “Operating activities.” The remaining balance of the liabilities is reported in “Accounts payable, accrued liabilities and other” in the accompanying consolidated balance sheets. 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. September 30, 2022 December 31, 2021 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 792 $ 715 $ 791 $ 829 3.875% Notes due 2030 642 541 642 675 3.875% Notes due 2032 741 612 740 760 Total $ 2,175 $ 1,868 $ 2,173 $ 2,264

Investments

Investments	9 Months Ended
	Sep. 30, 2022
Investments, Debt and Equity Securities [Abstract]
Investments	Investments Available-for-Sale We consider all of our investments classified as current assets to be available-for-sale. The following tables summarize our current investments as of the dates indicated: September 30, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,431 $ — $ 148 $ 2,283 Mortgage-backed securities 804 — 61 743 Asset-backed securities 322 — 19 303 Municipal securities 159 — 11 148 U.S. Treasury notes 117 — 1 116 Other 49 — 3 46 Total $ 3,882 $ — $ 243 $ 3,639 December 31, 2021 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,836 $ 9 $ 12 $ 1,833 Mortgage-backed securities 616 2 4 614 Asset-backed securities 248 — 1 247 Municipal securities 123 1 1 123 U.S. Treasury notes 353 — — 353 Other 32 — — 32 Total $ 3,208 $ 12 $ 18 $ 3,202 The contractual maturities of our current investments as of September 30, 2022 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 378 $ 374 Due after one year through five years 2,330 2,186 Due after five years through ten years 390 364 Due after ten years 784 715 Total $ 3,882 $ 3,639 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 nine months ended September 30, 2022, respectively. Gross realized investment gains amounted to $6 million and $7 million for the three and nine months ended September 30, 2021, respectively. Gross realized investment losses were insignificant for the three and nine months ended September 30, 2022, and 2021. We have determined that unrealized losses at September 30, 2022, and December 31, 2021, 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 segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of September 30, 2022: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,764 $ 103 909 $ 433 $ 45 167 Mortgage-backed securities 555 36 282 188 25 75 Asset-backed securities 242 13 128 56 6 28 Municipal securities 106 7 110 31 4 35 U.S. Treasury notes 116 1 8 — — — Other 32 3 20 — — — Total $ 2,815 $ 163 1,457 $ 708 $ 80 305 The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of December 31, 2021: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,063 $ 12 395 $ — $ — — Mortgage-backed securities 408 4 146 — — — Asset-backed securities 166 1 75 — — — Municipal securities 69 1 61 — — — Total $ 1,706 $ 18 677 $ — $ — — Restricted Investments 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, U.S. Treasury securities, and corporate debt 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 $242 million at September 30, 2022, of which $201 million will mature in one year or less, $37 million will mature in one through five years, and $4 million will mature after five years.

Medical Claims and Benefits Pay

Medical Claims and Benefits Payable	9 Months Ended
	Sep. 30, 2022
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: September 30, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,553 $ 2,486 Pharmacy payable 241 219 Capitation payable 90 82 Other 738 576 Total $ 3,622 $ 3,363 “Other” medical claims and benefits payable include 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 $317 million and $226 million as of September 30, 2022, and December 31, 2021, respectively. The following tables present the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported. Nine Months Ended September 30, 2022 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,580 $ 404 $ 379 $ 3,363 Components of medical care costs related to: Current year 16,520 2,525 1,476 20,521 Prior years (282) (38) (18) (338) Total medical care costs 16,238 2,487 1,458 20,183 Payments for medical care costs related to: Current year 14,133 2,103 1,302 17,538 Prior years 1,861 337 283 2,481 Total paid 15,994 2,440 1,585 20,019 Acquired balances, net of post-acquisition adjustments 8 — — 8 Change in non-risk and other provider payables 91 (4) — 87 Medical claims and benefits payable, ending balance $ 2,923 $ 447 $ 252 $ 3,622 Nine Months Ended September 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 13,491 2,195 1,872 17,558 Prior years (158) (36) (22) (216) Total medical care costs 13,333 2,159 1,850 17,342 Payments for medical care costs related to: Current year 11,530 1,816 1,534 14,880 Prior years 1,538 340 130 2,008 Total paid 13,068 2,156 1,664 16,888 Acquired balances, net of post-acquisition adjustments (19) (8) — (27) Change in non-risk and other provider payables 68 — — 68 Medical claims and benefits payable, ending balance $ 2,443 $ 387 $ 361 $ 3,191 Our estimates of medical claims and benefits payable recorded at December 31, 2021, and 2020 developed favorably by approximately $338 million and $216 million as of September 30, 2022, and 2021, respectively. The favorable prior year development recognized in the nine months ended September 30, 2022 was primarily due to lower than expected utilization of medical services by our members and improved operating performance. Consequently, the ultimate costs recognized in 2022, as claims payments were processed, were lower than our estimates in 2021.

Debt

Debt	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Debt	Debt All our 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: September 30, December 31, (In millions) Non-current long-term debt: 4.375% Notes due 2028 $ 800 $ 800 3.875% Notes due 2030 650 650 3.875% Notes due 2032 750 750 Deferred debt issuance costs (25) (27) Total $ 2,175 $ 2,173 Credit Agreement We are party to a credit agreement (the “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 September 30, 2022, we were in compliance with all financial and non-financial covenants under the Credit Agreement. As of September 30, 2022, no amounts were outstanding under the Credit Facility. Senior Notes Our senior notes are described below. Each of these notes are senior unsecured obligations of Molina 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. In addition, each of the indentures governing the senior notes contain customary non-financial covenants and change of control provisions. As of September 30, 2022, we were in compliance with all non-financial covenants in the indentures governing the senior notes. The indentures governing the 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 September 30, 2022, 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. 3.875% Notes due 2030. We had $650 million aggregate principal amount of senior notes (the “3.875% Notes due 2030”) outstanding as of September 30, 2022, 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	9 Months Ended
	Sep. 30, 2022
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity In September 2021, our board of directors authorized the purchase of up to $500 million, in the aggregate, of our common stock. This new program, which superseded the stock purchase program approved by our board of directors in September 2020, is funded with cash on hand and extends through December 31, 2022. 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 658,000 shares for $200 million in the second quarter of 2022 (average cost of $304.13 per share).

Segments

Segments	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Segments	Segments We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve. 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 provide in Wisconsin. The key metrics used to assess the performance of our Medicaid, Medicare, and Marketplace segments are premium revenue, medical margin and medical care ratio (“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. The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented. Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 (In millions) Total revenue: Medicaid $ 6,380 $ 5,354 $ 19,091 $ 15,583 Medicare 955 875 2,867 2,502 Marketplace 575 793 1,740 2,224 Other 17 18 53 53 Total $ 7,927 $ 7,040 $ 23,751 $ 20,362 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 (In millions) Margin: Medicaid $ 703 $ 532 $ 2,168 $ 1,687 Medicare 108 151 360 329 Marketplace 77 68 255 331 Other 2 4 8 11 Total margin 890 755 2,791 2,358 Add: other operating revenues (1) 274 222 732 620 Less: other operating expenses (2) (829) (756) (2,455) (2,149) Operating income 335 221 1,068 829 Other expenses, net 28 30 83 90 Income before income tax expense $ 307 $ 191 $ 985 $ 739 ______________________ (1) Other operating revenues include premium tax revenue, investment income, and other revenue. (2) Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and other operating expenses.

Commitments and Contingencies

Commitments and Contingencies	9 Months Ended
	Sep. 30, 2022
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 on our business 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 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. Penalties associated with violations of these laws and regulations include significant fines and penalties, exclusion from participating in publicly funded programs, the repayment of previously billed and collected revenues and reputational damage. 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 our Kentucky health plan. On September 9, 2022, the Court of Appeal ruled, among other things, that the Circuit Court should not have invalidated the 2020 procurement and thus should not have awarded a contract to Anthem. Anthem filed a petition for rehearing with the Kentucky Court of Appeals and will likely seek review by the Kentucky Supreme Court. Pending further Court order, our Kentucky health plan will continue to operate for the foreseeable future under its current Medicaid contract. Puerto Rico. On August 13, 2021, Molina Healthcare of Puerto Rico, Inc. (“MHPR”) filed a complaint against the Puerto Rico Health Insurance Administration (“ASES”), asserting, among other claims, breach of contract. On September 13, 2021, ASES filed a counterclaim and a third-party complaint against MHPR and the Company. This matter remains subject to significant additional proceedings, and no prediction can be made as to the outcome.

Significant Accounting Polici_2

Significant Accounting Policies (Policies)	9 Months Ended
	Sep. 30, 2022
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, these financial statements reflect all normal recurring adjustments, which are considered necessary for a fair presentation of the results as of the dates and for the interim periods presented. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the nine months ended September 30, 2022 are not necessarily indicative of the results for the entire year ending December 31, 2022.
Use of Estimates	Use of EstimatesThe 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.
Cash and Cash Equivalents	Cash and Cash EquivalentsCash 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.
Receivables	Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all of 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 Amounts Due Government Agencies and Contractual Provisions That May Adjust or Limit Revenue or Profit	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 2021 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 Program 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, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. Beginning in 2020, various states enacted temporary risk corridors in response to the reduced demand for medical services stemming from COVID-1 9 , 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. Since the second quarter of 2020, we have recognized risk corridors that we believe to be probable, and where the ultimate premium amount is reasonably estimable. For the three and nine months ended September 30, 2022, we recognized approximately $34 million and $156 million, respectively, related to such risk corridors, primarily in the Medicaid segment, compared to $17 million and $183 million, respectively, recognized in the three and nine months ended September 30, 2021. The decrease is due to the elimination of several of the COVID-19 risk corridors. It is possible that certain states could change the structure of existing risk corridors, implement new risk corridors in the future or discontinue existing risk corridors. 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 Program
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 15 years, or less than 15 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 governments of each state 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 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 have, nor does management expect such pronouncements to have, a significant impact on our present or future consolidated financial statements.

Significant Accounting Polici_3

Significant Accounting Policies (Tables)	9 Months Ended
	Sep. 30, 2022
Accounting Policies [Abstract]
Schedule of Cash and Cash Equivalents	The following table provides a reconciliation of cash and 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. September 30, 2022 2021 (In millions) Cash and cash equivalents $ 4,242 $ 4,357 Restricted cash and cash equivalents 53 78 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,295 $ 4,435
Schedule of Restricted Cash and Cash Equivalents	The following table provides a reconciliation of cash and 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. September 30, 2022 2021 (In millions) Cash and cash equivalents $ 4,242 $ 4,357 Restricted cash and cash equivalents 53 78 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,295 $ 4,435
Schedule of Receivables	September 30, December 31, (In millions) Government receivables $ 1,545 $ 1,566 Pharmacy rebate receivables 290 276 Other 385 335 Total $ 2,220 $ 2,177
Schedule of 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. The following table sets forth amounts due government agencies, categorized by program: September 30, December 31, (In millions) Medicaid program: Minimum MLR and profit sharing $ 1,091 $ 1,016 Other 617 263 Medicare program: Minimum MLR and profit sharing 100 101 Risk adjustment and Part D risk sharing 74 89 Other 23 35 Marketplace program: Risk adjustment 179 902 Minimum MLR 4 18 Other 51 48 Total amounts due government agencies $ 2,139 $ 2,472

Net Income Per Share (Tables)

Net Income Per Share (Tables)	9 Months Ended
	Sep. 30, 2022
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 basic and diluted net income per share: Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 (In millions, except net income per share) Numerator: Net income $ 230 $ 143 $ 736 $ 556 Denominator: Shares outstanding at the beginning of the period 57.6 57.8 57.9 58.0 Weighted-average number of shares issued: Stock-based compensation — — 0.2 0.3 Stock purchases — — (0.3) (0.5) Denominator for basic net income per share 57.6 57.8 57.8 57.8 Effect of dilutive securities: (1) Stock-based compensation 0.7 0.7 0.7 0.7 Denominator for diluted net income per share 58.3 58.5 58.5 58.5 Net income per share - Basic (2) $ 4.00 $ 2.49 $ 12.74 $ 9.63 Net income per share - Diluted (2) $ 3.95 $ 2.46 $ 12.58 $ 9.51 ______________________________ (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)	9 Months Ended
	Sep. 30, 2022
Fair Value Disclosures [Abstract]
Schedule of Fair Value of Assets Measured on Recurring Basis	Our financial instruments measured at fair value on a recurring basis at September 30, 2022, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 2,283 $ — $ 2,283 $ — Mortgage-backed securities 743 — 743 — Asset-backed securities 303 — 303 — Municipal securities 148 — 148 — U.S. Treasury notes 116 — 116 — Other 46 — 46 — Total assets $ 3,639 $ — $ 3,639 $ — Contingent consideration liabilities $ 8 $ — $ — $ 8 Total liabilities $ 8 $ — $ — $ 8 Our financial instruments measured at fair value on a recurring basis at December 31, 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 $ 1,833 $ — $ 1,833 $ — Mortgage-backed securities 614 — 614 — Asset-backed securities 247 — 247 — Municipal securities 123 — 123 — U.S. Treasury notes 353 — 353 — Other 32 — 32 — Total assets $ 3,202 $ — $ 3,202 $ — Contingent consideration liabilities $ 47 $ — $ — $ 47 Total liabilities $ 47 $ — $ — $ 47
Schedule of Fair Value Measurements of Senior Notes	September 30, 2022 December 31, 2021 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 792 $ 715 $ 791 $ 829 3.875% Notes due 2030 642 541 642 675 3.875% Notes due 2032 741 612 740 760 Total $ 2,175 $ 1,868 $ 2,173 $ 2,264

Investments (Tables)

Investments (Tables)	9 Months Ended
	Sep. 30, 2022
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	The following tables summarize our current investments as of the dates indicated: September 30, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,431 $ — $ 148 $ 2,283 Mortgage-backed securities 804 — 61 743 Asset-backed securities 322 — 19 303 Municipal securities 159 — 11 148 U.S. Treasury notes 117 — 1 116 Other 49 — 3 46 Total $ 3,882 $ — $ 243 $ 3,639 December 31, 2021 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 1,836 $ 9 $ 12 $ 1,833 Mortgage-backed securities 616 2 4 614 Asset-backed securities 248 — 1 247 Municipal securities 123 1 1 123 U.S. Treasury notes 353 — — 353 Other 32 — — 32 Total $ 3,208 $ 12 $ 18 $ 3,202
Schedule of Contractual Maturities of Investments	The contractual maturities of our current investments as of September 30, 2022 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 378 $ 374 Due after one year through five years 2,330 2,186 Due after five years through ten years 390 364 Due after ten years 784 715 Total $ 3,882 $ 3,639
Schedule of Available-for-Sale Investments	The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of September 30, 2022: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,764 $ 103 909 $ 433 $ 45 167 Mortgage-backed securities 555 36 282 188 25 75 Asset-backed securities 242 13 128 56 6 28 Municipal securities 106 7 110 31 4 35 U.S. Treasury notes 116 1 8 — — — Other 32 3 20 — — — Total $ 2,815 $ 163 1,457 $ 708 $ 80 305 The following table segregates those available-for-sale investments that have been in a continuous loss position for less than 12 months, and those that have been in a continuous loss position for 12 months or more as of December 31, 2021: In a Continuous Loss Position In a Continuous Loss Position Estimated Unrealized Total Number of Positions Estimated Unrealized Total Number of Positions (Dollars in millions) Corporate debt securities $ 1,063 $ 12 395 $ — $ — — Mortgage-backed securities 408 4 146 — — — Asset-backed securities 166 1 75 — — — Municipal securities 69 1 61 — — — Total $ 1,706 $ 18 677 $ — $ — —

Medical Claims and Benefits P_2

Medical Claims and Benefits Payable (Tables)	9 Months Ended
	Sep. 30, 2022
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: September 30, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,553 $ 2,486 Pharmacy payable 241 219 Capitation payable 90 82 Other 738 576 Total $ 3,622 $ 3,363
Schedule of Components of The Change in Medical Claims and Benefits Payable	The following tables present the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported. Nine Months Ended September 30, 2022 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,580 $ 404 $ 379 $ 3,363 Components of medical care costs related to: Current year 16,520 2,525 1,476 20,521 Prior years (282) (38) (18) (338) Total medical care costs 16,238 2,487 1,458 20,183 Payments for medical care costs related to: Current year 14,133 2,103 1,302 17,538 Prior years 1,861 337 283 2,481 Total paid 15,994 2,440 1,585 20,019 Acquired balances, net of post-acquisition adjustments 8 — — 8 Change in non-risk and other provider payables 91 (4) — 87 Medical claims and benefits payable, ending balance $ 2,923 $ 447 $ 252 $ 3,622 Nine Months Ended September 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 13,491 2,195 1,872 17,558 Prior years (158) (36) (22) (216) Total medical care costs 13,333 2,159 1,850 17,342 Payments for medical care costs related to: Current year 11,530 1,816 1,534 14,880 Prior years 1,538 340 130 2,008 Total paid 13,068 2,156 1,664 16,888 Acquired balances, net of post-acquisition adjustments (19) (8) — (27) Change in non-risk and other provider payables 68 — — 68 Medical claims and benefits payable, ending balance $ 2,443 $ 387 $ 361 $ 3,191

Debt (Tables)

Debt (Tables)	9 Months Ended
	Sep. 30, 2022
Debt Disclosure [Abstract]
Schedule of Long Term Debt	The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below: September 30, December 31, (In millions) Non-current long-term debt: 4.375% Notes due 2028 $ 800 $ 800 3.875% Notes due 2030 650 650 3.875% Notes due 2032 750 750 Deferred debt issuance costs (25) (27) Total $ 2,175 $ 2,173

Segments (Tables)

Segments (Tables)	9 Months Ended
	Sep. 30, 2022
Segment Reporting [Abstract]
Schedule of Operating Segment Information	The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented. Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 (In millions) Total revenue: Medicaid $ 6,380 $ 5,354 $ 19,091 $ 15,583 Medicare 955 875 2,867 2,502 Marketplace 575 793 1,740 2,224 Other 17 18 53 53 Total $ 7,927 $ 7,040 $ 23,751 $ 20,362 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended September 30, Nine Months Ended September 30, 2022 2021 2022 2021 (In millions) Margin: Medicaid $ 703 $ 532 $ 2,168 $ 1,687 Medicare 108 151 360 329 Marketplace 77 68 255 331 Other 2 4 8 11 Total margin 890 755 2,791 2,358 Add: other operating revenues (1) 274 222 732 620 Less: other operating expenses (2) (829) (756) (2,455) (2,149) Operating income 335 221 1,068 829 Other expenses, net 28 30 83 90 Income before income tax expense $ 307 $ 191 $ 985 $ 739 ______________________ (1) Other operating revenues include premium tax revenue, investment income, and other revenue. (2) Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and other operating expenses.

Organization and Basis of Pre_2

Organization and Basis of Presentation (Details) member in Millions, $ in Millions		1 Months Ended			9 Months Ended
	Jul. 13, 2022 USD ($)	Sep. 30, 2022 state member	Aug. 31, 2022 contract	Sep. 30, 2021	Sep. 30, 2022 segment state member
Segment Reporting Information [Line Items]
Reportable segments | segment					4
Contract term				4 years
Extension option				2 years
MCW
Segment Reporting Information [Line Items]
Purchase price | $	$ 150
NEBRASKA
Segment Reporting Information [Line Items]
Contract term		5 years
Extension option		2 years
IOWA
Segment Reporting Information [Line Items]
Contract term			4 years
Extension option			4 years
CALIFORNIA
Segment Reporting Information [Line Items]
Number of contracts | contract			5
MISSISSIPPI
Segment Reporting Information [Line Items]
Contract term			4 years
Extension option			2 years
Health Plans
Segment Reporting Information [Line Items]
Number of members eligible for the health care programs, approximately | member		5.2			5.2
Number of states with programs | state		19			19
Health Plans | Minimum
Segment Reporting Information [Line Items]
Contract term					3 years
Health Plans | Maximum
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	Sep. 30, 2022	Dec. 31, 2021	Sep. 30, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Cash and cash equivalents	$ 4,242	$ 4,438	$ 4,357
Restricted cash and cash equivalents	53		78
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$ 4,295	$ 4,506	$ 4,435	$ 4,223

Significant Accounting Polici_5

Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	$ 2,220	$ 2,177
Government receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	1,545	1,566
Pharmacy rebate receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	290	276
Other
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	$ 385	$ 335

Significant Accounting Polici_6

Significant Accounting Policies - Amounts Due To Government Agencies (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Medicaid program:
Minimum MLR and profit sharing	$ 1,091	$ 1,016
Other	617	263
Medicare program:
Minimum MLR and profit sharing	100	101
Risk adjustment and Part D risk sharing	74	89
Other	23	35
Marketplace program:
Risk adjustment	179	902
Minimum MLR	4	18
Other	51	48
Total amounts due government agencies	$ 2,139	$ 2,472

Significant Accounting Polici_7

Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Schedule of Premium Revenue by Health Plan Type [Line Items]
Risk adjustment payable	$ 179		$ 179		$ 902
Risk adjustment receivable	94		94		7
Risk adjustment, net payable	85		$ 85		$ 895
Maturity period (less than)			15 years
Structured Securities
Schedule of Premium Revenue by Health Plan Type [Line Items]
Average maturity period (less than)			15 years
COVID-19
Schedule of Premium Revenue by Health Plan Type [Line Items]
Reduction in premiums	$ 34	$ 17	$ 156	$ 183

Net Income Per Share (Details)

Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended						9 Months Ended
	Sep. 30, 2022	Jun. 30, 2022	Mar. 31, 2022	Sep. 30, 2021	Jun. 30, 2021	Mar. 31, 2021	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021	Dec. 31, 2020
Numerator:
Net income	$ 230	$ 248	$ 258	$ 143	$ 185	$ 228	$ 736	$ 556
Denominator:
Shares outstanding at the beginning of the period ( in shares)		57.6			57.8				57.9	58
Weighted-average number of shares issued:
Stock-based compensation (in shares)	0			0			0.2	0.3
Stock purchases (in shares)	0			0			(0.3)	(0.5)
Denominator for basic net income per share (in shares)	57.6			57.8			57.8	57.8
Effect of dilutive securities:
Stock-based compensation (in shares)	0.7			0.7			0.7	0.7
Denominator for diluted net income per share (in shares)	58.3			58.5			58.5	58.5
Net income per share:
Net income per share - Basic (in dollars per share)	$ 4			$ 2.49			$ 12.74	$ 9.63
Net income per share - Diluted (in dollars per share)	$ 3.95			$ 2.46			$ 12.58	$ 9.51

Business Combinations (Details)

Business Combinations (Details) - USD ($) $ in Millions				9 Months Ended
	Sep. 30, 2022	Jan. 01, 2022	Oct. 25, 2021	Sep. 30, 2022
AgeWell
Business Acquisition, Contingent Consideration [Line Items]
Total purchase price	$ 134
Cigna Corporation's Texas Medicaid and Medicare-Medicaid Plan
Business Acquisition, Contingent Consideration [Line Items]
Total purchase price		$ 60
Goodwill		24
Cigna Corporation's Texas Medicaid and Medicare-Medicaid Plan | Member list
Business Acquisition, Contingent Consideration [Line Items]
Acquired membership with a preliminary fair value		$ 36
Affinity Health Plan, Inc
Business Acquisition, Contingent Consideration [Line Items]
Total purchase price			$ 176
Goodwill				$ 7
Medical claims and benefits payable				8
Increase to receivables, net of amounts due government agencies				$ 1

Fair Value Measurements - Finan

Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	$ 3,639	$ 3,202
Total assets	3,639	3,202
Contingent consideration liabilities	8	47
Total liabilities	8	47
Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	2,283	1,833
Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	743	614
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	303	247
Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	148	123
U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	116	353
Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	46	32
(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	0
(Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	3,639	3,202
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	2,283	1,833
(Level 2) | Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	743	614
(Level 2) | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	303	247
(Level 2) | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	148	123
(Level 2) | U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	116	353
(Level 2) | Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	46	32
(Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities		47
Total liabilities	8	47
(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	$ 0

Fair Value Measurements - Narra

Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Recognized gain (loss)	$ 4	$ 3
Contingent consideration liabilities	8		$ 47
Contingent consideration liabilities settled	20	$ 20
(Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration liabilities			$ 47
Passport Health Plan, Inc.
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration paid to seller included in financing and operating activities	43
Passport Health Plan, Inc. | Minimum Member Enrollment Targets
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Remaining half of contingent consideration paid	23
Passport Health Plan, Inc. | Operating Income Guarantee
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration liabilities settled	20
Passport Health Plan, Inc. | (Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration liabilities	$ 8

Fair Value Measurements - Long-

Fair Value Measurements - Long-Term Debt (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 2,175	$ 2,173
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 1,868	2,264
Senior Notes | 4.375% Notes due 2028
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	4.375%
Senior Notes | 4.375% Notes due 2028 | Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 792	791
Senior Notes | 4.375% Notes due 2028 | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 715	829
Senior Notes | 3.875% Notes due 2030
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	3.875%
Senior Notes | 3.875% Notes due 2030 | Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 642	642
Senior Notes | 3.875% Notes due 2030 | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 541	675
Senior Notes | 3.875% Notes due 2032
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	3.875%
Senior Notes | 3.875% Notes due 2032 | Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 741	740
Senior Notes | 3.875% Notes due 2032 | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 612	$ 760

Investments - Summary of Invest

Investments - Summary of Investments (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 3,882	$ 3,208
Gross unrealized gains	0	12
Gross unrealized losses	243	18
Estimated Fair Value	3,639	3,202
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,431	1,836
Gross unrealized gains	0	9
Gross unrealized losses	148	12
Estimated Fair Value	2,283	1,833
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	804	616
Gross unrealized gains	0	2
Gross unrealized losses	61	4
Estimated Fair Value	743	614
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	322	248
Gross unrealized gains	0	0
Gross unrealized losses	19	1
Estimated Fair Value	303	247
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	159	123
Gross unrealized gains	0	1
Gross unrealized losses	11	1
Estimated Fair Value	148	123
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	117	353
Gross unrealized gains	0	0
Gross unrealized losses	1	0
Estimated Fair Value	116	353
Other
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	49	32
Gross unrealized gains	0	0
Gross unrealized losses	3	0
Estimated Fair Value	$ 46	$ 32

Investments - Contractual Matur

Investments - Contractual Maturities of Available-for-Sale Investments (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Amortized Cost
Due in one year or less	$ 378
Due after one year through five years	2,330
Due after five years through ten years	390
Due after ten years	784
Amortized Cost	3,882	$ 3,208
Estimated Fair Value
Due in one year or less	374
Due after one year through five years	2,186
Due after five years through ten years	364
Due after ten years	715
Total	$ 3,639

Investments - Narrative (Detail

Investments - Narrative (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Investments, Debt and Equity Securities [Abstract]
Gross realized investment gains	$ 0	$ 6	$ 0	$ 7
Gross realized investment losses	0	$ 0	0	$ 0
Debt securities held to maturity	242		242
Amortized cost, due in one year or less	201		201
Amortized cost, due one year through five years	37		37
Amortized cost, due after five years	$ 4		$ 4

Investments - Available-for-Sal

Investments - Available-for-Sale Investments (Details) $ in Millions	Sep. 30, 2022 USD ($) security position	Dec. 31, 2021 USD ($) position security
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 2,815	$ 1,706
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 163	$ 18
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	1,457	677
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 708	$ 0
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 80	$ 0
In a Continuous Loss Position for 12 Months or More, Total Number of Positions	305	0
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 1,764	$ 1,063
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 103	$ 12
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	909	395
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 433	$ 0
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 45	$ 0
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position	167	0
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 555	$ 408
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 36	$ 4
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	282	146
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 188	$ 0
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 25	$ 0
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position	75	0
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 242	$ 166
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 13	$ 1
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | security	128	75
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 56	$ 0
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 6	$ 0
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | security	28	0
Municipal securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 106	$ 69
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 7	$ 1
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | security	110	61
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 31	$ 0
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 4	$ 0
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | security	35	0
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 116
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 1
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | security	8
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 0
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 0
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | security	0
Other
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 32
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 3
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | security	20
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 0
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 0
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | security	0

Medical Claims and Benefits P_3

Medical Claims and Benefits Payable - Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021	Sep. 30, 2021	Dec. 31, 2020
Other Liabilities Disclosure [Abstract]
Claims incurred but not paid (“IBNP”)	$ 2,553	$ 2,486
Pharmacy payable	241	219
Capitation payable	90	82
Other	738	576
Total	$ 3,622	$ 3,363	$ 3,191	$ 2,696

Medical Claims and Benefits P_4

Medical Claims and Benefits Payable - Narrative (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Dec. 31, 2021
Other Liabilities Disclosure [Abstract]
Non-risk provider payables	$ 317		$ 226
Prior period claims, favorable development	$ (338)	$ (216)

Medical Claims and Benefits P_5

Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021
Insurance Claims
Medical claims and benefits payable, beginning balance	$ 3,363	$ 2,696
Components of medical care costs related to:
Current year	20,521	17,558
Prior years	(338)	(216)
Total medical care costs	20,183	17,342
Payments for medical care costs related to:
Current year	17,538	14,880
Prior years	2,481	2,008
Total paid	20,019	16,888
Acquired balances, net of post-acquisition adjustments	8	(27)
Change in non-risk and other provider payables	87	68
Medical claims and benefits payable, ending balance	3,622	3,191
Medicaid
Insurance Claims
Medical claims and benefits payable, beginning balance	2,580	2,129
Components of medical care costs related to:
Current year	16,520	13,491
Prior years	(282)	(158)
Total medical care costs	16,238	13,333
Payments for medical care costs related to:
Current year	14,133	11,530
Prior years	1,861	1,538
Total paid	15,994	13,068
Acquired balances, net of post-acquisition adjustments	8	(19)
Change in non-risk and other provider payables	91	68
Medical claims and benefits payable, ending balance	2,923	2,443
Medicare
Insurance Claims
Medical claims and benefits payable, beginning balance	404	392
Components of medical care costs related to:
Current year	2,525	2,195
Prior years	(38)	(36)
Total medical care costs	2,487	2,159
Payments for medical care costs related to:
Current year	2,103	1,816
Prior years	337	340
Total paid	2,440	2,156
Acquired balances, net of post-acquisition adjustments	0	(8)
Change in non-risk and other provider payables	(4)	0
Medical claims and benefits payable, ending balance	447	387
Marketplace
Insurance Claims
Medical claims and benefits payable, beginning balance	379	175
Components of medical care costs related to:
Current year	1,476	1,872
Prior years	(18)	(22)
Total medical care costs	1,458	1,850
Payments for medical care costs related to:
Current year	1,302	1,534
Prior years	283	130
Total paid	1,585	1,664
Acquired balances, net of post-acquisition adjustments	0	0
Change in non-risk and other provider payables	0	0
Medical claims and benefits payable, ending balance	$ 252	$ 361

Debt - Schedule of Long-Term De

Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions	Sep. 30, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Deferred debt issuance costs	$ (25)	$ (27)
Total	$ 2,175	2,173
Senior Notes | 4.375% Notes due 2028
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.375%
Non-current portion of long-term debt	$ 800	800
Senior Notes | 3.875% Notes due 2030
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Non-current portion of long-term debt	$ 650	650
Senior Notes | 3.875% Notes due 2032
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Non-current portion of long-term debt	$ 750	$ 750

Debt - Narrative (Details)

Debt - Narrative (Details)	9 Months Ended
	Sep. 30, 2022 USD ($)
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 due 2028
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.375%
Face amount	$ 800,000,000
Senior Notes | 3.875% Notes due 2030
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Face amount	$ 650,000,000
Senior Notes | 3.875% Notes due 2032
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Face amount	$ 750,000,000

Stockholders' Equity (Details)

Stockholders' Equity (Details) - USD ($) $ / shares in Units, shares in Thousands	3 Months Ended		9 Months Ended
	Jun. 30, 2022	Mar. 31, 2021	Sep. 30, 2022	Sep. 30, 2021
Class of Stock [Line Items]
Common stock purchases			$ 200,000,000	$ 128,000,000
Common Stock
Class of Stock [Line Items]
Common stock authorized				$ 500,000,000
Repurchased of common stock (in shares)	658	1,000
Common stock purchases	$ 200,000,000
Average cost (USD per share)	$ 304.13

Segments - Narrative (Details)

Segments - Narrative (Details)	9 Months Ended
	Sep. 30, 2022 segment
Segment Reporting [Abstract]
Reportable segments	4

Segments - Schedule of Operatin

Segments - Schedule of Operating Segment Information (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Segment Reporting Information [Line Items]
Revenues	$ 7,927	$ 7,040	$ 23,751	$ 20,362
Medicaid
Segment Reporting Information [Line Items]
Revenues	6,380	5,354	19,091	15,583
Medicare
Segment Reporting Information [Line Items]
Revenues	955	875	2,867	2,502
Marketplace
Segment Reporting Information [Line Items]
Revenues	575	793	1,740	2,224
Other
Segment Reporting Information [Line Items]
Revenues	$ 17	$ 18	$ 53	$ 53

Segments - Reconciliation of Gr

Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions	3 Months Ended		9 Months Ended
	Sep. 30, 2022	Sep. 30, 2021	Sep. 30, 2022	Sep. 30, 2021
Segment Reporting Information [Line Items]
Add: other operating revenues	$ 7,927	$ 7,040	$ 23,751	$ 20,362
Less: other operating expenses	(7,592)	(6,819)	(22,683)	(19,533)
Operating income	335	221	1,068	829
Other expenses, net	28	30	83	90
Income before income tax expense	307	191	985	739
Medicaid
Segment Reporting Information [Line Items]
Add: other operating revenues	6,380	5,354	19,091	15,583
Medicare
Segment Reporting Information [Line Items]
Add: other operating revenues	955	875	2,867	2,502
Marketplace
Segment Reporting Information [Line Items]
Add: other operating revenues	575	793	1,740	2,224
Other
Segment Reporting Information [Line Items]
Add: other operating revenues	17	18	53	53
Operating segments
Segment Reporting Information [Line Items]
Total margin	890	755	2,791	2,358
Operating segments | Medicaid
Segment Reporting Information [Line Items]
Total margin	703	532	2,168	1,687
Operating segments | Medicare
Segment Reporting Information [Line Items]
Total margin	108	151	360	329
Operating segments | Marketplace
Segment Reporting Information [Line Items]
Total margin	77	68	255	331
Operating segments | Other
Segment Reporting Information [Line Items]
Total margin	2	4	8	11
Other operating
Segment Reporting Information [Line Items]
Add: other operating revenues	274	222	732	620
Less: other operating expenses	$ (829)	$ (756)	$ (2,455)	$ (2,149)