Income Taxes (Tables)

12 Months Ended

Dec. 31, 2022

Income Tax Disclosure [Abstract]

Schedule of Provision for Income Taxes

The provision for income taxes consists of the following (dollars in millions):

	2022		2021			2020
Current:
Federal	$	1,222	$	1,769		$	1,021
State		206		311			126
Foreign		18		15			5
Deferred:
Federal		261		24			(73	)
State		27		(18	)		(39	)
Foreign		12		11			3
	$	1,746	$	2,112		$	1,043

Schedule of Reconciliation of Federal Statutory Rate to Effective Income Tax Rate

A reconciliation of the federal statutory rate to the effective income tax rate follows:

	2022			2021			2020
Federal statutory rate		21.0	%		21.0	%		21.0	%
State income taxes, net of federal tax benefit		2.3			2.0			1.9
Change in liability for uncertain tax positions		0.7			0.7			(0.2	)
Tax benefit from settlements of employee equity awards		(0.9	)		(1.2	)		(1.8	)
Other items, net		0.5			0.8			0.8
Effective income tax rate on income attributable to HCA Healthcare, Inc.		23.6			23.3			21.7
Income attributable to noncontrolling interests from consolidated partnerships		(3.3	)		(1.8	)		(2.5	)
Effective income tax rate on income before income taxes		20.3	%		21.5	%		19.2	%

NOTE 4 — INCOME TAXES (continued)

Schedule of Deferred Tax Assets and Liabilities

A summary of the items comprising our deferred tax assets and liabilities at December 31 follows (dollars in millions):

	2022				2021
	Assets		Liabilities		Assets		Liabilities
Depreciation and fixed asset basis differences	$	—	$	938	$	—	$	737
Allowances for professional liability and other risks		430				426		—
Accounts receivable		368				348		—
Compensation		402				502		—
Right-of-use lease assets and obligations		451		438		428		419
Other		536		698		499		652
	$	2,187	$	2,074	$	2,203	$	1,808

Schedule of Activity Related to our Gross Unrecognized Tax Benefits

The following table summarizes the activity related to our gross unrecognized tax benefits, excluding accrued interest of $129 million and $99 million as of December 31, 2022 and 2021, respectively (dollars in millions):

	2022			2021
Balance at January 1	$	576		$	469
Additions based on tax positions related to the current year		25			57
Additions for tax positions of prior years		50			66
Reductions for tax positions of prior years		(4	)		(6	)
Settlements		(1	)		(3	)
Lapse of applicable statutes of limitations		(7	)		(7	)
Balance at December 31	$	639		$	576