Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2020	Sep. 30, 2019
Cash flows from operating activities
Net income	$ 3,641	$ 2,195
Adjustments to reconcile net income to net cash provided by operating activities:
Gains on investment securities, net	(696)	(23)
Equity in net earnings	(68)	(16)
Stock-based compensation	129	119
Depreciation	390	382
Amortization	66	53
Benefit for deferred income taxes	(3)	(21)
Changes in operating assets and liabilities, net of effect of businesses acquired and dispositions:
Receivables	(82)	179
Other assets	(1,547)	334
Benefits payable	2,204	1,358
Other liabilities	1,257	168
Unearned revenues	40	(9)
Other	25	53
Net cash provided by operating activities	5,356	4,772
Cash flows from investing activities
Acquisitions, net of cash acquired	(709)	0
Purchases of property and equipment	(668)	(506)
Purchases of investment securities	(7,230)	(4,130)
Maturities of investment securities	3,500	1,281
Proceeds from sales of investment securities	2,097	2,878
Net cash used in investing activities	(3,010)	(477)
Cash flows from financing activities
(Withdrawals) receipts from contract deposits, net	(274)	11
Proceeds from issuance of senior notes, net	1,088	987
Proceeds (repayments) from issuance of commercial paper, net	21
Proceeds (repayments) from issuance of commercial paper, net		(358)
Proceeds from term loan	1,000	0
Repayments of Notes Payable	0	(650)
Change in book overdraft	(11)	102
Common stock repurchases	(30)	(1,010)
Dividends paid	(239)	(216)
Proceeds from stock option exercises and other, net	30	23
Net cash provided by (used in) financing activities	1,585	(1,111)
Increase in cash and cash equivalents	3,931	3,184
Cash and cash equivalents at beginning of period	4,054	2,343
Cash and cash equivalents at end of period	7,985	5,527
Supplemental cash flow disclosures:
Interest payments	159	136
Income tax payments, net	$ 778	$ 578