Molina Healthcare (MOH) 10-Q 27 Apr 23 2023 Q1 Quarterly report Financial data

Cover Page

Cover Page - shares shares in Thousands	3 Months Ended
	Mar. 31, 2023	Apr. 21, 2023
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2023
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		58,300
Entity Central Index Key	0001179929
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2023
Document Fiscal Period Focus	Q1
Amendment Flag	false

CONSOLIDATED STATEMENTS OF INCO

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Revenue:
Premium revenue	$ 7,885	$ 7,531
Premium tax revenue	172	208
Investment income	71	11
Other revenue	21	20
Total revenue	8,149	7,770
Operating expenses:
Medical care costs	6,871	6,563
General and administrative expenses	591	571
Premium tax expenses	172	208
Depreciation and amortization	44	40
Other	16	16
Total operating expenses	7,694	7,398
Operating income	455	372
Other expenses, net:
Interest expense	28	28
Total other expenses, net	28	28
Income before income tax expense	427	344
Income tax expense	106	86
Net income	$ 321	$ 258
Net income per share:
Net income per share - Basic (in dollars per share)	$ 5.58	$ 4.45
Net income per share - Diluted (in dollars per share)	$ 5.52	$ 4.39

CONSOLIDATED STATEMENTS OF COMP

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Statement of Comprehensive Income [Abstract]
Net income	$ 321	$ 258
Other comprehensive gain (loss):
Unrealized investment gain (loss)	46	(100)
Less: effect of income taxes	11	(24)
Other comprehensive gain (loss), net of tax	35	(76)
Comprehensive income	$ 356	$ 182

CONSOLIDATED BALANCE SHEETS

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Current assets:
Cash and cash equivalents	$ 4,554	$ 4,006
Investments	3,810	3,499
Receivables	2,536	2,302
Prepaid expenses and other current assets	259	277
Total current assets	11,159	10,084
Property, equipment, and capitalized software, net	274	259
Goodwill, and intangible assets, net	1,369	1,390
Restricted investments	242	238
Deferred income taxes	208	220
Other assets	119	123
Total assets	13,371	12,314
Current liabilities:
Medical claims and benefits payable	3,824	3,528
Amounts due government agencies	2,349	2,079
Accounts payable, accrued liabilities and other	787	889
Deferred revenue	654	359
Total current liabilities	7,614	6,855
Long-term debt	2,177	2,176
Finance lease liabilities	204	215
Other long-term liabilities	88	104
Total liabilities	10,083	9,350
Stockholders’ equity:
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 58 million shares at March 31, 2023 and December 31, 2022	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	296	328
Accumulated other comprehensive loss	(125)	(160)
Retained earnings	3,117	2,796
Total stockholders’ equity	3,288	2,964
Total liabilities and stockholders’ equity	$ 13,371	$ 12,314

CONSOLIDATED BALANCE SHEETS (Pa

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2023	Dec. 31, 2022
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 Millions, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive (Loss) Income	Retained Earnings
Beginning balance (in shares) at Dec. 31, 2021		58
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 income, net	(76)			(76)
Share-based compensation (in shares)		1
Share-based compensation	(18)		(18)
Ending balance (in shares) at Mar. 31, 2022		59
Ending balance at Mar. 31, 2022	2,794	$ 0	218	(81)	2,657
Beginning balance (in shares) at Dec. 31, 2022		58
Beginning balance at Dec. 31, 2022	2,964	$ 0	328	(160)	2,796
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	321				321
Other comprehensive income, net	35			35
Share-based compensation	(32)		(32)
Ending balance (in shares) at Mar. 31, 2023		58
Ending balance at Mar. 31, 2023	$ 3,288	$ 0	$ 296	$ (125)	$ 3,117

CONSOLIDATED STATEMENTS OF CASH

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Operating activities:
Net income	$ 321	$ 258
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	44	40
Deferred income taxes	1	16
Share-based compensation	25	34
Other, net	5	(8)
Changes in operating assets and liabilities:
Receivables	(234)	21
Prepaid expenses and other current assets	7	(32)
Medical claims and benefits payable	296	263
Amounts due government agencies	270	137
Accounts payable, accrued liabilities and other	(215)	(81)
Deferred revenue	295	(352)
Income taxes	101	67
Net cash provided by operating activities	916	363
Investing activities:
Purchases of investments	(646)	(403)
Proceeds from sales and maturities of investments	371	513
Purchases of property, equipment and capitalized software	(32)	(23)
Other, net	5	(13)
Net cash (used in) provided by investing activities	(302)	74
Financing activities:
Common stock withheld to settle employee tax obligations	(58)	(52)
Contingent consideration liabilities settled	0	(20)
Other, net	(7)	(5)
Net cash used in financing activities	(65)	(77)
Net increase in cash, cash equivalents, and restricted cash and cash equivalents	549	360
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	4,048	4,506
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$ 4,597	$ 4,866

Organization and Basis of Prese

Organization and Basis of Presentation	3 Months Ended
	Mar. 31, 2023
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 March 31, 2023, we served approximately 5.3 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. In Medicare, we enter into Medicare Advantage-Part D contracts with the Centers for Medicare and Medicaid Services (“CMS”) annually, and for dual-eligible plans, we enter into contracts with CMS, in partnership with each state’s department of health and human services. Such contracts typically have terms of one In Marketplace, we enter into contracts with CMS, which end on December 31 of each year, and must be renewed annually. Recent Developments Indiana Procurement—Medicaid. In March 2023, we announced that the Indiana Department of Administration has recommended that contract negotiations begin with our Indiana health plan. Under the proposed contract with the Indiana Family and Social Services Administration (“FSSA”), we are expected to provide risk-based managed care long term services and supports as part of the Indiana Pathways for Aging LTSS program pursuant to the request for proposal issued by FSSA in February 2022. The new contract is expected to have an initial four-year term, with the potential for two one-year renewal terms. 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 three months ended March 31, 2023 are not necessarily indicative of the results for the entire year ending December 31, 2023. 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, 2022. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2022, 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, 2022. Use of Estimates

Significant Accounting Policies

Significant Accounting Policies	3 Months Ended
	Mar. 31, 2023
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. March 31, 2023 2022 (In millions) Cash and cash equivalents $ 4,554 $ 4,804 Restricted cash and cash equivalents 43 62 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,597 $ 4,866 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. March 31, December 31, (In millions) Government receivables $ 1,896 $ 1,702 Pharmacy rebate receivables 275 291 Other 365 309 Total $ 2,536 $ 2,302 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, including certain components of premium revenue that are subject to accounting estimates and are described below, and in our 2022 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. Categorized by program, such amounts due government agencies included the following: March 31, December 31, (In millions) Medicaid program: Minimum MLR, corridors, and profit sharing $ 1,302 $ 1,145 Other premium adjustments 557 482 Medicare program: Minimum MLR and profit sharing 85 84 Risk adjustment and Part D risk sharing 61 76 Other premium adjustments 27 27 Marketplace program: Risk adjustment 278 230 Minimum MLR 1 2 Other premium adjustments 38 33 Total amounts due government agencies $ 2,349 $ 2,079 Medicaid Program Minimum MLR and Medical Cost Corridors. A portion of our premium revenue may be returned if certain minimum amounts are not spent on defined medical care costs as a percentage of premium revenue, or minimum medical loss ratio (“Minimum MLR”). Under certain medical cost corridor provisions, the health plans may refund premiums or receive additional premiums, depending on whether amounts spent on medical care costs fall below or exceed defined thresholds. This includes remaining risk corridors that were enacted by various states in 2020 in response to the reduced demand for medical services stemming from COVID-19. Profit Sharing. Our contracts with certain states contain profit sharing provisions under which we refund amounts to the states if our health plans generate profit above a certain specified percentage. In some cases, we are limited in the amount of administrative costs that we may deduct in calculating the refund, if any. Other Premium Adjustments. State Medicaid programs periodically adjust premium revenues on a retroactive basis for rate changes and changes in membership and eligibility data. In certain states, adjustments are made based on the health status of our members (as measured through a risk score). 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. 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 for all plan participants in a state (risk adjustment payable), and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score for all plan participants in a state (risk adjustment receivable). Under CMS rules, the Marketplace risk adjustment pool is budget neutral. We estimate our ultimate premium based on insurance policy year-to-date experience, and the data submitted and expected to be submitted to CMS, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income. As of March 31, 2023, Marketplace risk adjustment estimated payables amounted to $278 million and estimated receivables amounted to $173 million, for a net payable of $105 million. As of December 31, 2022, Marketplace risk adjustment estimated payables amounted to $230 million and estimated receivables amounted to $135 million, for a net payable of $95 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, U.S. Treasury securities, and corporate debt 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	3 Months Ended
	Mar. 31, 2023
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 March 31, 2023 2022 (In millions, except net income per share) Numerator: Net income $ 321 $ 258 Denominator: Shares outstanding at the beginning of the period 57.4 57.9 Weighted-average number of shares issued: Stock-based compensation 0.1 0.1 Denominator for basic net income per share 57.5 58.0 Effect of dilutive securities: (1) Stock-based compensation 0.5 0.7 Denominator for diluted net income per share 58.0 58.7 Net income per share - Basic (2) $ 5.58 $ 4.45 Net income per share - Diluted (2) $ 5.52 $ 4.39 ______________________________ (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

Fair Value Measurements	3 Months Ended
	Mar. 31, 2023
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 2022 Annual Report on Form 10-K, Note 5, “Fair Value Measurements.” Our financial instruments measured at fair value on a recurring basis at March 31, 2023, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 2,335 $ — $ 2,335 $ — Mortgage-backed securities 851 — 851 — Asset-backed securities 323 — 323 — Municipal securities 151 — 151 — U.S. Treasury notes 123 — 123 — Other 27 — 27 — Total assets $ 3,810 $ — $ 3,810 $ — Our financial instruments measured at fair value on a recurring basis at December 31, 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 $ 2,184 $ — $ 2,184 $ — Mortgage-backed securities 731 — 731 — Asset-backed securities 288 — 288 — Municipal securities 149 — 149 — U.S. Treasury notes 105 — 105 — Other 42 — 42 — Total assets $ 3,499 $ — $ 3,499 $ — Contingent consideration liabilities $ 8 $ — $ — $ 8 Total liabilities $ 8 $ — $ — $ 8 Contingent Consideration Liabilities In the three months ended March 31, 2023, we paid $8 million in connection with our 2020 acquisition of certain assets of Passport Health Plan, Inc., which represented the final payment of the consideration due relating to an operating income guarantee. The amount paid in the three months ended March 31, 2023, has been presented in “Operating activities” in the accompanying consolidated statements of cash flows. 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. March 31, 2023 December 31, 2022 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 793 $ 742 $ 792 $ 729 3.875% Notes due 2030 643 568 643 554 3.875% Notes due 2032 741 637 741 629 Total $ 2,177 $ 1,947 $ 2,176 $ 1,912

Investments

Investments	3 Months Ended
	Mar. 31, 2023
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: March 31, 2023 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,428 $ 6 $ 99 $ 2,335 Mortgage-backed securities 897 2 48 851 Asset-backed securities 337 — 14 323 Municipal securities 160 — 9 151 U.S. Treasury notes 123 — — 123 Other 29 — 2 27 Total $ 3,974 $ 8 $ 172 $ 3,810 December 31, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,303 $ 2 $ 121 $ 2,184 Mortgage-backed securities 787 — 56 731 Asset-backed securities 308 — 20 288 Municipal securities 160 — 11 149 U.S. Treasury notes 106 — 1 105 Other 45 — 3 42 Total $ 3,709 $ 2 $ 212 $ 3,499 The contractual maturities of our current investments as of March 31, 2023 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 280 $ 277 Due after one year through five years 2,340 2,245 Due after five years through ten years 455 443 Due after ten years 899 845 Total $ 3,974 $ 3,810 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 months ended March 31, 2023, and 2022. Gross realized investments losses amounted to $10 million in the three months ended March 31, 2023, and were reclassified into earnings from other comprehensive income on a net-of-tax basis. Gross realized investment losses were insignificant in the three months ended March 31, 2022. We have determined that unrealized losses at March 31, 2023, and December 31, 2022, 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 March 31, 2023: 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 $ 719 $ 15 480 $ 1,107 $ 84 510 Mortgage-backed securities 257 6 144 467 42 228 Asset-backed securities 134 2 76 133 12 73 Municipal securities 48 1 28 83 8 105 Other 8 1 9 10 1 7 Total $ 1,166 $ 25 737 $ 1,800 $ 147 923 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, 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 $ 1,124 $ 45 683 $ 887 $ 76 371 Mortgage-backed securities 395 20 220 319 36 131 Asset-backed securities 161 6 108 118 14 59 Municipal securities 75 4 83 57 7 57 U.S. Treasury notes 88 1 6 — — — Other 15 1 16 17 2 6 Total $ 1,858 $ 77 1,116 $ 1,398 $ 135 624 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 March 31, 2023, of which $123 million will mature in one year or less, $111 million will mature in one through five years, and $8 million will mature after five years.

Medical Claims and Benefits Pay

Medical Claims and Benefits Payable	3 Months Ended
	Mar. 31, 2023
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: March 31, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,589 $ 2,597 Pharmacy payable 233 206 Capitation payable 95 94 Other 907 631 Total $ 3,824 $ 3,528 “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 $493 million and $228 million as of March 31, 2023, and December 31, 2022, 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. Three Months Ended March 31, 2023 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,815 $ 452 $ 261 $ 3,528 Components of medical care costs related to: Current year 5,865 934 370 7,169 Prior years (250) (14) (34) (298) Total medical care costs 5,615 920 336 6,871 Payments for medical care costs related to: Current year 3,728 542 217 4,487 Prior years 1,822 369 167 2,358 Total paid 5,550 911 384 6,845 Acquired balances, net of post-acquisition adjustments — — — — Change in non-risk and other provider payables 270 — — 270 Medical claims and benefits payable, ending balance $ 3,150 $ 461 $ 213 $ 3,824 Three Months Ended March 31, 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 5,424 840 505 6,769 Prior years (154) (25) (27) (206) Total medical care costs 5,270 815 478 6,563 Payments for medical care costs related to: Current year 3,402 465 330 4,197 Prior years 1,633 306 260 2,199 Total paid 5,035 771 590 6,396 Acquired balances, net of post-acquisition adjustments (25) — — (25) Change in non-risk and other provider payables 93 3 — 96 Medical claims and benefits payable, ending balance $ 2,883 $ 451 $ 267 $ 3,601 Our estimates of medical claims and benefits payable recorded at December 31, 2022, and 2021 developed favorably by approximately $298 million and $206 million as of March 31, 2023, and 2022, respectively. The favorable prior year development recognized in the three months ended March 31, 2023 was primarily due to lower than expected utilization of medical services by our members and improved operating performance. Consequently, the ultimate costs recognized in 2023, as claims payments were processed, were lower than our estimates in 2022.

Debt

Debt	3 Months Ended
	Mar. 31, 2023
Debt Disclosure [Abstract]
Debt	Debt The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below: March 31, 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 (23) (24) Total $ 2,177 $ 2,176 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. Effective April 26, 2023, we amended the Credit Agreement to transition from the use of the London Interbank Offered Rate, or LIBOR, to the Secured Overnight Financing Rate, or SOFR, as a benchmark interest rate used in the Credit Agreement. We have other relationships, including financial advisory and banking, with some parties to the Credit Agreement. The Credit Agreement contains customary non-financial and financial covenants. As of March 31, 2023, we were in compliance with all financial and non-financial covenants under the Credit Agreement. As of March 31, 2023, no amounts were outstanding under the Credit Facility. For an understanding of the terms and provisions of the Credit Agreement, reference should be made to the copy of the agreement attached as Exhibit 10.1 to this Form 10-Q and incorporated by reference herein. Senior Notes Our senior notes are described below. Each of these notes are senior unsecured obligations of the parent corporation, Molina Healthcare, Inc., and rank equally in right of payment with all existing and future senior debt, and senior to all existing and future subordinated debt of Molina Healthcare, Inc. In addition, each of the indentures governing the senior notes contain customary non-financial covenants and change of control provisions. As of March 31, 2023, 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 March 31, 2023, 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 March 31, 2023, 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.

Segments

Segments	3 Months Ended
	Mar. 31, 2023
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 long-term services and supports consultative services 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 March 31, 2023 2022 (In millions) Total revenue: Medicaid $ 6,578 $ 6,187 Medicare 1,056 949 Marketplace 497 616 Other 18 18 Total $ 8,149 $ 7,770 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended March 31, 2023 2022 (In millions) Margin: Medicaid $ 734 $ 710 Medicare 126 128 Marketplace 154 130 Other 2 3 Total margin 1,016 971 Add: other operating revenues (1) 246 221 Less: other operating expenses (2) (807) (820) Operating income 455 372 Other expenses, net 28 28 Income before income tax expense $ 427 $ 344 ______________________ (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	3 Months Ended
	Mar. 31, 2023
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies 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 Kentucky Court of Appeals ruled that, with regard to the earlier Circuit Court ruling granting Anthem relief, the Circuit Court should not have invalidated the 2020 procurement and thus should not have awarded a contract to Anthem. Anthem sought discretionary review by the Kentucky Supreme Court of the ruling by the Court of Appeals. On April 19, 2023, the Kentucky Supreme Court granted Anthem’s request for discretionary review and ordered legal briefing. 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 with the Commonwealth of Puerto Rico, Court of First Instance, San Juan (State Court) asserting, among other claims, breach of contract against Puerto Rico Health Insurance Administration (“ASES”). 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)	3 Months Ended
	Mar. 31, 2023
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 three months ended March 31, 2023 are not necessarily indicative of the results for the entire year ending December 31, 2023.
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, including certain components of premium revenue that are subject to accounting estimates and are described below, and in our 2022 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.” Medicaid Program Minimum MLR and Medical Cost Corridors. A portion of our premium revenue may be returned if certain minimum amounts are not spent on defined medical care costs as a percentage of premium revenue, or minimum medical loss ratio (“Minimum MLR”). Under certain medical cost corridor provisions, the health plans may refund premiums or receive additional premiums, depending on whether amounts spent on medical care costs fall below or exceed defined thresholds. This includes remaining risk corridors that were enacted by various states in 2020 in response to the reduced demand for medical services stemming from COVID-19.
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, U.S. Treasury securities, and corporate debt 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)	3 Months Ended
	Mar. 31, 2023
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. March 31, 2023 2022 (In millions) Cash and cash equivalents $ 4,554 $ 4,804 Restricted cash and cash equivalents 43 62 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,597 $ 4,866
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. March 31, 2023 2022 (In millions) Cash and cash equivalents $ 4,554 $ 4,804 Restricted cash and cash equivalents 43 62 Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows $ 4,597 $ 4,866
Schedule of Receivables	March 31, December 31, (In millions) Government receivables $ 1,896 $ 1,702 Pharmacy rebate receivables 275 291 Other 365 309 Total $ 2,536 $ 2,302
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. Categorized by program, such amounts due government agencies included the following: March 31, December 31, (In millions) Medicaid program: Minimum MLR, corridors, and profit sharing $ 1,302 $ 1,145 Other premium adjustments 557 482 Medicare program: Minimum MLR and profit sharing 85 84 Risk adjustment and Part D risk sharing 61 76 Other premium adjustments 27 27 Marketplace program: Risk adjustment 278 230 Minimum MLR 1 2 Other premium adjustments 38 33 Total amounts due government agencies $ 2,349 $ 2,079

Net Income Per Share (Tables)

Net Income Per Share (Tables)	3 Months Ended
	Mar. 31, 2023
Earnings Per Share [Abstract]
Schedule 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 March 31, 2023 2022 (In millions, except net income per share) Numerator: Net income $ 321 $ 258 Denominator: Shares outstanding at the beginning of the period 57.4 57.9 Weighted-average number of shares issued: Stock-based compensation 0.1 0.1 Denominator for basic net income per share 57.5 58.0 Effect of dilutive securities: (1) Stock-based compensation 0.5 0.7 Denominator for diluted net income per share 58.0 58.7 Net income per share - Basic (2) $ 5.58 $ 4.45 Net income per share - Diluted (2) $ 5.52 $ 4.39 ______________________________ (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)	3 Months Ended
	Mar. 31, 2023
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 March 31, 2023, were as follows: Observable Inputs Directly or Indirectly Observable Inputs Unobservable Inputs Total (Level 1) (Level 2) (Level 3) (In millions) Corporate debt securities $ 2,335 $ — $ 2,335 $ — Mortgage-backed securities 851 — 851 — Asset-backed securities 323 — 323 — Municipal securities 151 — 151 — U.S. Treasury notes 123 — 123 — Other 27 — 27 — Total assets $ 3,810 $ — $ 3,810 $ — Our financial instruments measured at fair value on a recurring basis at December 31, 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 $ 2,184 $ — $ 2,184 $ — Mortgage-backed securities 731 — 731 — Asset-backed securities 288 — 288 — Municipal securities 149 — 149 — U.S. Treasury notes 105 — 105 — Other 42 — 42 — Total assets $ 3,499 $ — $ 3,499 $ — Contingent consideration liabilities $ 8 $ — $ — $ 8 Total liabilities $ 8 $ — $ — $ 8
Schedule of Fair Value Measurements of Senior Notes	March 31, 2023 December 31, 2022 Carrying Fair Value Carrying Fair Value (In millions) 4.375% Notes due 2028 $ 793 $ 742 $ 792 $ 729 3.875% Notes due 2030 643 568 643 554 3.875% Notes due 2032 741 637 741 629 Total $ 2,177 $ 1,947 $ 2,176 $ 1,912

Investments (Tables)

Investments (Tables)	3 Months Ended
	Mar. 31, 2023
Investments, Debt and Equity Securities [Abstract]
Schedule of Investments	The following tables summarize our current investments as of the dates indicated: March 31, 2023 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,428 $ 6 $ 99 $ 2,335 Mortgage-backed securities 897 2 48 851 Asset-backed securities 337 — 14 323 Municipal securities 160 — 9 151 U.S. Treasury notes 123 — — 123 Other 29 — 2 27 Total $ 3,974 $ 8 $ 172 $ 3,810 December 31, 2022 Amortized Cost Gross Unrealized Estimated Fair Value Gains Losses (In millions) Corporate debt securities $ 2,303 $ 2 $ 121 $ 2,184 Mortgage-backed securities 787 — 56 731 Asset-backed securities 308 — 20 288 Municipal securities 160 — 11 149 U.S. Treasury notes 106 — 1 105 Other 45 — 3 42 Total $ 3,709 $ 2 $ 212 $ 3,499
Schedule of Contractual Maturities of Investments	The contractual maturities of our current investments as of March 31, 2023 are summarized below: Amortized Cost Estimated (In millions) Due in one year or less $ 280 $ 277 Due after one year through five years 2,340 2,245 Due after five years through ten years 455 443 Due after ten years 899 845 Total $ 3,974 $ 3,810
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 March 31, 2023: 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 $ 719 $ 15 480 $ 1,107 $ 84 510 Mortgage-backed securities 257 6 144 467 42 228 Asset-backed securities 134 2 76 133 12 73 Municipal securities 48 1 28 83 8 105 Other 8 1 9 10 1 7 Total $ 1,166 $ 25 737 $ 1,800 $ 147 923 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, 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 $ 1,124 $ 45 683 $ 887 $ 76 371 Mortgage-backed securities 395 20 220 319 36 131 Asset-backed securities 161 6 108 118 14 59 Municipal securities 75 4 83 57 7 57 U.S. Treasury notes 88 1 6 — — — Other 15 1 16 17 2 6 Total $ 1,858 $ 77 1,116 $ 1,398 $ 135 624

Medical Claims and Benefits P_2

Medical Claims and Benefits Payable (Tables)	3 Months Ended
	Mar. 31, 2023
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: March 31, December 31, (In millions) Claims incurred but not paid (“IBNP”) $ 2,589 $ 2,597 Pharmacy payable 233 206 Capitation payable 95 94 Other 907 631 Total $ 3,824 $ 3,528
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. Three Months Ended March 31, 2023 Medicaid Medicare Marketplace Consolidated (In millions) Medical claims and benefits payable, beginning balance $ 2,815 $ 452 $ 261 $ 3,528 Components of medical care costs related to: Current year 5,865 934 370 7,169 Prior years (250) (14) (34) (298) Total medical care costs 5,615 920 336 6,871 Payments for medical care costs related to: Current year 3,728 542 217 4,487 Prior years 1,822 369 167 2,358 Total paid 5,550 911 384 6,845 Acquired balances, net of post-acquisition adjustments — — — — Change in non-risk and other provider payables 270 — — 270 Medical claims and benefits payable, ending balance $ 3,150 $ 461 $ 213 $ 3,824 Three Months Ended March 31, 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 5,424 840 505 6,769 Prior years (154) (25) (27) (206) Total medical care costs 5,270 815 478 6,563 Payments for medical care costs related to: Current year 3,402 465 330 4,197 Prior years 1,633 306 260 2,199 Total paid 5,035 771 590 6,396 Acquired balances, net of post-acquisition adjustments (25) — — (25) Change in non-risk and other provider payables 93 3 — 96 Medical claims and benefits payable, ending balance $ 2,883 $ 451 $ 267 $ 3,601

Debt (Tables)

Debt (Tables)	3 Months Ended
	Mar. 31, 2023
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: March 31, 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 (23) (24) Total $ 2,177 $ 2,176

Segments (Tables)

Segments (Tables)	3 Months Ended
	Mar. 31, 2023
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 March 31, 2023 2022 (In millions) Total revenue: Medicaid $ 6,578 $ 6,187 Medicare 1,056 949 Marketplace 497 616 Other 18 18 Total $ 8,149 $ 7,770 The following table reconciles margin by segment to consolidated income before income taxes. Three Months Ended March 31, 2023 2022 (In millions) Margin: Medicaid $ 734 $ 710 Medicare 126 128 Marketplace 154 130 Other 2 3 Total margin 1,016 971 Add: other operating revenues (1) 246 221 Less: other operating expenses (2) (807) (820) Operating income 455 372 Other expenses, net 28 28 Income before income tax expense $ 427 $ 344 ______________________ (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	1 Months Ended	3 Months Ended
	Mar. 31, 2023 state option member	Mar. 31, 2023 segment state member
Segment Reporting Information [Line Items]
Reportable segments | segment		4
Indiana Procurement
Segment Reporting Information [Line Items]
Contract term	4 years
Number of potential for renewals | option	2
Renewal term	1 year
Health Plans
Segment Reporting Information [Line Items]
Number of members eligible for the health care programs, approximately | member	5.3	5.3
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
Health and Human Services | Minimum
Segment Reporting Information [Line Items]
Contract term		1 year
Health and Human Services | Maximum
Segment Reporting Information [Line Items]
Contract term		3 years

Significant Accounting Polici_4

Significant Accounting Policies - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021
Accounting Policies [Abstract]
Cash and cash equivalents	$ 4,554	$ 4,006	$ 4,804
Restricted cash and cash equivalents	43		62
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$ 4,597	$ 4,048	$ 4,866	$ 4,506

Significant Accounting Polici_5

Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	$ 2,536	$ 2,302
Government receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	1,896	1,702
Pharmacy rebate receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	275	291
Other
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	$ 365	$ 309

Significant Accounting Polici_6

Significant Accounting Policies - Amounts Due To Government Agencies (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Medicaid program:
Minimum MLR, corridors, and profit sharing	$ 1,302	$ 1,145
Other premium adjustments	557	482
Medicare program:
Minimum MLR and profit sharing	85	84
Risk adjustment and Part D risk sharing	61	76
Other premium adjustments	27	27
Marketplace program:
Risk adjustment	278	230
Minimum MLR	1	2
Other premium adjustments	38	33
Total amounts due government agencies	$ 2,349	$ 2,079

Significant Accounting Polici_7

Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Dec. 31, 2022
Schedule of Premium Revenue by Health Plan Type [Line Items]
Risk adjustment payable	$ 278	$ 230
Risk adjustment receivable	173	135
Risk adjustment, net payable	$ 105	$ 95
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

Net Income Per Share (Details)

Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022	Dec. 31, 2021
Numerator:
Net income	$ 321	$ 258
Denominator:
Shares outstanding at the beginning of the period (in shares)			57.4	57.9
Weighted-average number of shares issued:
Stock-based compensation (in shares)	0.1	0.1
Denominator for basic net income per share (in shares)	57.5	58
Effect of dilutive securities:
Stock-based compensation (in shares)	0.5	0.7
Denominator for diluted net income per share (in shares)	58	58.7
Net income per share:
Net income per share - Basic (in dollars per share)	$ 5.58	$ 4.45
Net income per share - Diluted (in dollars per share)	$ 5.52	$ 4.39

Fair Value Measurements - Finan

Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	$ 3,810	$ 3,499
Total assets	3,810	3,499
Contingent consideration liabilities		8
Total liabilities		8
Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	2,335	2,184
Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	851	731
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	323	288
Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	151	149
U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	123	105
Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	27	42
(Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities		0
Total liabilities		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	3,810	3,499
Contingent consideration liabilities		0
Total liabilities		0
(Level 2) | Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	2,335	2,184
(Level 2) | Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	851	731
(Level 2) | Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	323	288
(Level 2) | Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	151	149
(Level 2) | U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	123	105
(Level 2) | Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	27	42
(Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities		8
Total liabilities		8
(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) $ in Millions	3 Months Ended
	Mar. 31, 2023 USD ($)
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	$ 8

Fair Value Measurements - Long-

Fair Value Measurements - Long-Term Debt (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 2,177	$ 2,176
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 1,947	1,912
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	$ 793	792
Senior Notes | 4.375% Notes due 2028 | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 742	729
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	$ 643	643
Senior Notes | 3.875% Notes due 2030 | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 568	554
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	741
Senior Notes | 3.875% Notes due 2032 | Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 637	$ 629

Investments - Summary of Invest

Investments - Summary of Investments (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 3,974	$ 3,709
Gross unrealized gains	8	2
Gross unrealized losses	172	212
Estimated Fair Value	3,810	3,499
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	2,428	2,303
Gross unrealized gains	6	2
Gross unrealized losses	99	121
Estimated Fair Value	2,335	2,184
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	897	787
Gross unrealized gains	2	0
Gross unrealized losses	48	56
Estimated Fair Value	851	731
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	337	308
Gross unrealized gains	0	0
Gross unrealized losses	14	20
Estimated Fair Value	323	288
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	160	160
Gross unrealized gains	0	0
Gross unrealized losses	9	11
Estimated Fair Value	151	149
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	123	106
Gross unrealized gains	0	0
Gross unrealized losses	0	1
Estimated Fair Value	123	105
Other
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	29	45
Gross unrealized gains	0	0
Gross unrealized losses	2	3
Estimated Fair Value	$ 27	$ 42

Investments - Contractual Matur

Investments - Contractual Maturities of Available-for-Sale Investments (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Amortized Cost
Due in one year or less	$ 280
Due after one year through five years	2,340
Due after five years through ten years	455
Due after ten years	899
Amortized Cost	3,974	$ 3,709
Estimated Fair Value
Due in one year or less	277
Due after one year through five years	2,245
Due after five years through ten years	443
Due after ten years	845
Total	$ 3,810

Investments - Narrative (Detail

Investments - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Investments, Debt and Equity Securities [Abstract]
Gross realized investment gains	$ 0	$ 0
Gross realized investment losses	10	$ 0
Debt securities held to maturity	242
Amortized cost, due in one year or less	123
Amortized cost, due one year through five years	111
Amortized cost, due after five years	$ 8

Investments - Available-for-Sal

Investments - Available-for-Sale Investments (Details) $ in Millions	Mar. 31, 2023 USD ($) position	Dec. 31, 2022 USD ($) position
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 1,166	$ 1,858
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 25	$ 77
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	737	1,116
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 1,800	$ 1,398
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 147	$ 135
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position	923	624
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 719	$ 1,124
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 15	$ 45
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	480	683
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 1,107	$ 887
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 84	$ 76
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position	510	371
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 257	$ 395
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 6	$ 20
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	144	220
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 467	$ 319
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 42	$ 36
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position	228	131
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 134	$ 161
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 2	$ 6
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	76	108
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 133	$ 118
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 12	$ 14
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position	73	59
Municipal securities
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 48	$ 75
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 1	$ 4
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	28	83
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 83	$ 57
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 8	$ 7
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position	105	57
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value		$ 88
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 | position		6
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 | position		0
Other
Debt Securities, Available-for-sale [Line Items]
In a Continuous Loss Position for Less than 12 Months, Estimated Fair Value	$ 8	$ 15
In a Continuous Loss Position for Less than 12 Months, Gross Unrealized Losses	$ 1	$ 1
In a Continuous Loss Position for Less than 12 Months, Total Number of Positions | position	9	16
In a Continuous Loss Position for 12 Months or More, Estimated Fair Value	$ 10	$ 17
In a Continuous Loss Position for 12 Months or More, Gross Unrealized Losses	$ 1	$ 2
In a Continuous Loss Position for 12 Months or More, Total Number of Positions | position	7	6

Medical Claims and Benefits P_3

Medical Claims and Benefits Payable - Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022	Mar. 31, 2022	Dec. 31, 2021
Other Liabilities Disclosure [Abstract]
Claims incurred but not paid (“IBNP”)	$ 2,589	$ 2,597
Pharmacy payable	233	206
Capitation payable	95	94
Other	907	631
Total	$ 3,824	$ 3,528	$ 3,601	$ 3,363

Medical Claims and Benefits P_4

Medical Claims and Benefits Payable - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022	Dec. 31, 2022
Other Liabilities Disclosure [Abstract]
Non-risk provider payables	$ 493		$ 228
Prior period claims, favorable development	$ (298)	$ (206)

Medical Claims and Benefits P_5

Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Insurance Claims
Medical claims and benefits payable, beginning balance	$ 3,528	$ 3,363
Components of medical care costs related to:
Current year	7,169	6,769
Prior years	(298)	(206)
Total medical care costs	6,871	6,563
Payments for medical care costs related to:
Current year	4,487	4,197
Prior years	2,358	2,199
Total paid	6,845	6,396
Acquired balances, net of post-acquisition adjustments	0	(25)
Change in non-risk and other provider payables	270	96
Medical claims and benefits payable, ending balance	3,824	3,601
Medicaid
Insurance Claims
Medical claims and benefits payable, beginning balance	2,815	2,580
Components of medical care costs related to:
Current year	5,865	5,424
Prior years	(250)	(154)
Total medical care costs	5,615	5,270
Payments for medical care costs related to:
Current year	3,728	3,402
Prior years	1,822	1,633
Total paid	5,550	5,035
Acquired balances, net of post-acquisition adjustments	0	(25)
Change in non-risk and other provider payables	270	93
Medical claims and benefits payable, ending balance	3,150	2,883
Medicare
Insurance Claims
Medical claims and benefits payable, beginning balance	452	404
Components of medical care costs related to:
Current year	934	840
Prior years	(14)	(25)
Total medical care costs	920	815
Payments for medical care costs related to:
Current year	542	465
Prior years	369	306
Total paid	911	771
Acquired balances, net of post-acquisition adjustments	0	0
Change in non-risk and other provider payables	0	3
Medical claims and benefits payable, ending balance	461	451
Marketplace
Insurance Claims
Medical claims and benefits payable, beginning balance	261	379
Components of medical care costs related to:
Current year	370	505
Prior years	(34)	(27)
Total medical care costs	336	478
Payments for medical care costs related to:
Current year	217	330
Prior years	167	260
Total paid	384	590
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	$ 213	$ 267

Debt - Schedule of Long-Term De

Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions	Mar. 31, 2023	Dec. 31, 2022
Debt Instrument [Line Items]
Deferred debt issuance costs	$ (23)	$ (24)
Total	$ 2,177	2,176
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)	3 Months Ended
	Mar. 31, 2023 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

Segments - Narrative (Details)

Segments - Narrative (Details)	3 Months Ended
	Mar. 31, 2023 segment
Segment Reporting [Abstract]
Reportable segments	4

Segments - Operating Segment In

Segments - Operating Segment Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Revenues	$ 8,149	$ 7,770
Medicaid
Segment Reporting Information [Line Items]
Revenues	6,578	6,187
Medicare
Segment Reporting Information [Line Items]
Revenues	1,056	949
Marketplace
Segment Reporting Information [Line Items]
Revenues	497	616
Other
Segment Reporting Information [Line Items]
Revenues	$ 18	$ 18

Segments - Reconciliation of Gr

Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2023	Mar. 31, 2022
Segment Reporting Information [Line Items]
Add: other operating revenues	$ 8,149	$ 7,770
Less: other operating expenses	(7,694)	(7,398)
Operating income	455	372
Other expenses, net	28	28
Income before income tax expense	427	344
Medicaid
Segment Reporting Information [Line Items]
Add: other operating revenues	6,578	6,187
Medicare
Segment Reporting Information [Line Items]
Add: other operating revenues	1,056	949
Marketplace
Segment Reporting Information [Line Items]
Add: other operating revenues	497	616
Other
Segment Reporting Information [Line Items]
Add: other operating revenues	18	18
Operating segments
Segment Reporting Information [Line Items]
Total margin	1,016	971
Operating segments | Medicaid
Segment Reporting Information [Line Items]
Total margin	734	710
Operating segments | Medicare
Segment Reporting Information [Line Items]
Total margin	126	128
Operating segments | Marketplace
Segment Reporting Information [Line Items]
Total margin	154	130
Operating segments | Other
Segment Reporting Information [Line Items]
Total margin	2	3
Other operating
Segment Reporting Information [Line Items]
Add: other operating revenues	246	221
Less: other operating expenses	$ (807)	$ (820)