Condensed Consolidated Statements of Cash Flows - USD ($) $ in Millions	6 Months Ended
	Jun. 30, 2021	Jun. 30, 2020
Cash flows from operating activities
Net income	$ 1,416	$ 2,301
Adjustments to reconcile net income to net cash (used in) provided by operating activities:
Gains on investment securities, net	(86)	(51)
Equity in net earnings	(54)	(33)
Stock-based compensation	84	82
Depreciation	308	252
Amortization	30	43
Benefit for deferred income taxes	0	(3)
Changes in operating assets and liabilities, net of effect of businesses acquired and dispositions:
Receivables	(1,285)	(1,185)
Other assets	(879)	(2,124)
Benefits payable	300	1,976
Other liabilities	(301)	2,267
Unearned revenues	5	19
Other	(15)	(3)
Net cash (used in) provided by operating activities	(477)	3,541
Cash flows from investing activities
Acquisitions, net of cash acquired	(325)	(709)
Purchases of property and equipment	(619)	(418)
Purchases of investment securities	(5,307)	(5,464)
Maturities of investment securities	1,627	1,645
Proceeds from sales of investment securities	2,421	2,084
Net cash used in investing activities	(2,203)	(2,862)
Cash flows from financing activities
Receipts from contract deposits, net	1,183	389
Proceeds from issuance of senior notes, net	0	1,088
Proceeds from issuance of commercial paper, net	508	21
Proceeds from term loan	0	1,000
Debt issue costs	(21)	0
Change in book overdraft	(84)	85
Common stock repurchases	(33)	(25)
Dividends paid	(173)	(156)
Proceeds from stock option exercises and other, net	5	28
Net cash provided by financing activities	1,385	2,430
(Decrease) increase in cash and cash equivalents	(1,295)	3,109
Cash and cash equivalents at beginning of period	4,673	4,054
Cash and cash equivalents at end of period	3,378	7,163
Supplemental cash flow disclosures:
Interest payments	132	115
Income tax payments, net	$ 386	$ 36