CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($) $ in Millions	9 Months Ended
	Sep. 30, 2024	Sep. 30, 2023
Cash flows from operating activities
Net income	$ 1,897	$ 3,024
Adjustments to reconcile net income to net cash provided by operating activities:
(Gain) loss on investment securities, net	(10)	49
Equity in net losses	57	39
Stock-based compensation	153	142
Depreciation	682	628
Amortization	46	51
Impairment of property and equipment	129	31
Changes in operating assets and liabilities, net of effect of businesses acquired and disposed:
Receivables	(109)	(126)
Other assets	258	(935)
Benefits payable	884	870
Other liabilities	(498)	39
Unearned revenues	(71)	7,250
Other	76	53
Net cash provided by operating activities	3,494	11,115
Cash flows from investing activities
Acquisitions, net of cash and cash equivalents acquired	(37)	(223)
Purchases of property and equipment, net	(421)	(721)
Purchases of investment securities	(6,403)	(3,366)
Proceeds from maturities of investment securities	2,214	885
Proceeds from sales of investment securities	1,758	815
Net cash used in investing activities	(2,889)	(2,610)
Cash flows from financing activities
(Payments) receipts from contract deposits, net	(638)	2,481
Proceeds from issuance of senior notes, net	2,232	1,215
Repayments of senior notes	(48)	(1,719)
(Repayments) issuance of commercial paper, net	(895)	1,618
Repayment of term loan	0	(500)
Debt issue costs	(7)	(4)
Change in book overdraft	3	(52)
Common stock repurchases	(768)	(1,002)
Dividends paid	(323)	(320)
Other	261	(135)
Net cash (used in) provided by financing activities	(183)	1,582
Increase in cash and cash equivalents	422	10,087
Cash and cash equivalents at beginning of period	4,694	5,061
Cash and cash equivalents at end of period	5,116	15,148
Supplemental cash flow disclosures:
Interest payments	416	317
Income tax payments, net	570	957
Details of businesses acquired in purchase transactions:
Fair value of assets acquired, net of cash and cash equivalents acquired	49	454
Less: Fair value of liabilities assumed	(12)	(236)
Less: Noncontrolling interests acquired	0	5
Cash paid for acquired businesses, net of cash and cash equivalents acquired	$ 37	$ 223