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Investments (Notes)
 3 Months Ended
Mar. 31, 2024
Investments [Abstract]  
Investments [Text Block] Investments
A summary of debt securities by major security type is as follows:
(in millions)Amortized
Cost		Gross
Unrealized
Gains		Gross
Unrealized
Losses		Fair
Value
March 31, 2024
Debt securities - available-for-sale:
U.S. government and agency obligations$4,730 $1 $(262)$4,469 
State and municipal obligations7,228 7 (357)6,878 
Corporate obligations22,756 20 (1,225)21,551 
U.S. agency mortgage-backed securities9,395 7 (850)8,552 
Non-U.S. agency mortgage-backed securities2,901 1 (220)2,682 
Total debt securities - available-for-sale47,010 36 (2,914)44,132 
Debt securities - held-to-maturity:
U.S. government and agency obligations510 — (5)505 
State and municipal obligations28 — (3)25 
Corporate obligations59 — — 59 
Total debt securities - held-to-maturity597 — (8)589 
Total debt securities$47,607 $36 $(2,922)$44,721 
December 31, 2023
Debt securities - available-for-sale:
U.S. government and agency obligations$4,674 $3 $(234)$4,443 
State and municipal obligations7,636 39 (322)7,353 
Corporate obligations23,136 67 (1,186)22,017 
U.S. agency mortgage-backed securities8,982 22 (708)8,296 
Non-U.S. agency mortgage-backed securities3,023 3 (240)2,786 
Total debt securities - available-for-sale47,451 134 (2,690)44,895 
Debt securities - held-to-maturity:
U.S. government and agency obligations506 1 (6)501 
State and municipal obligations28 — (2)26 
Corporate obligations69 — — 69 
Total debt securities - held-to-maturity603 1 (8)596 
Total debt securities$48,054 $135 $(2,698)$45,491 
The Company held $4.1 billion and $4.9 billion of equity securities as of March 31, 2024 and December 31, 2023, respectively. The Company’s investments in equity securities primarily consist of venture investments and employee savings plan related investments. Additionally, the Company’s investments included $1.4 billion of equity method investments primarily in operating businesses in the health care sector as of March 31, 2024 and December 31, 2023. The allowance for credit losses on held-to-maturity securities at March 31, 2024 and December 31, 2023 was not material.
The amortized cost and fair value of debt securities as of March 31, 2024, by contractual maturity, were as follows:
Available-for-SaleHeld-to-Maturity
(in millions)Amortized
Cost		Fair
Value		Amortized
Cost		Fair
Value
Due in one year or less$4,430 $4,398 $336 $334 
Due after one year through five years14,686 14,061 219 216 
Due after five years through ten years10,690 9,813 24 23 
Due after ten years4,908 4,626 18 16 
U.S. agency mortgage-backed securities9,395 8,552 — — 
Non-U.S. agency mortgage-backed securities2,901 2,682 — — 
Total debt securities$47,010 $44,132 $597 $589 
The fair value of available-for-sale debt securities with gross unrealized losses by major security type and length of time that individual securities have been in a continuous unrealized loss position were as follows:
 Less Than 12 Months12 Months or Greater Total
(in millions)Fair
Value		Gross
Unrealized
Losses		Fair
Value		Gross
Unrealized
Losses		Fair
Value		Gross
Unrealized
Losses
March 31, 2024
Debt securities - available-for-sale:
U.S. government and agency obligations
$2,005 $(18)$2,053 $(244)$4,058 $(262)
State and municipal obligations1,736 (18)4,334 (339)6,070 (357)
Corporate obligations4,046 (33)13,881 (1,192)17,927 (1,225)
U.S. agency mortgage-backed securities2,686 (46)5,197 (804)7,883 (850)
Non-U.S. agency mortgage-backed securities
159 (1)2,265 (219)2,424 (220)
Total debt securities - available-for-sale$10,632 $(116)$27,730 $(2,798)$38,362 $(2,914)
December 31, 2023
Debt securities - available-for-sale:
U.S. government and agency obligations
$1,270 $(7)$2,077 $(227)$3,347 $(234)
State and municipal obligations907 (7)4,063 (315)4,970 (322)
Corporate obligations1,826 (17)14,696 (1,169)16,522 (1,186)
U.S. agency mortgage-backed securities1,337 (12)5,069 (696)6,406 (708)
Non-U.S. agency mortgage-backed securities
279 (6)2,202 (234)2,481 (240)
Total debt securities - available-for-sale$5,619 $(49)$28,107 $(2,641)$33,726 $(2,690)
The Company’s unrealized losses from debt securities as of March 31, 2024 were generated from approximately 32,000 positions out of a total of 39,000 positions. The Company believes that it will timely collect the principal and interest due on its debt securities that have an amortized cost in excess of fair value. The unrealized losses were primarily caused by interest rate increases and not by unfavorable changes in the credit quality associated with these securities which impacted the Company’s assessment on collectability of principal and interest. At each reporting period, the Company evaluates available-for-sale debt securities for any credit-related impairment when the fair value of the investment is less than its amortized cost. The Company evaluated the expected cash flows, the underlying credit quality and credit ratings of the issuers, noting no significant credit deterioration since purchase. As of March 31, 2024, the Company did not have the intent to sell any of the available-for-sale debt securities in an unrealized loss position. Therefore, the Company believes these losses to be temporary. The allowance for credit losses on available-for-sale debt securities at March 31, 2024 and December 31, 2023 was not material.