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


	2019			2018			2017
Current:
Federal	$	670		$	759		$	1,067
State		134			149			120
Foreign		17			23			19
Deferred:
Federal		254			9			423
State		29			13			3
Foreign		(5	)		(7	)		6

	$	1,099		$	946		$	1,638

The 2017 Tax Cuts and Jobs Act (“Tax Act”) significantly revised U.S. corporate income taxes, including lowering the statutory corporate tax rate from 35% to 21% beginning in 2018, imposing a mandatory

one-time

transition tax on undistributed foreign earnings and creating a new U.S. minimum tax on earnings of foreign subsidiaries. Our provision for income taxes for the year ended December

31, 2018 included tax benefits of $613 million (including $67 million related to the remeasurement of certain deferred tax assets and liabilities) related to the reduction in our effective tax rate under the Tax Act. We completed our analysis of the impact of the Tax Act during the fourth quarter of 2018, reducing our provision for income taxes for the year ended December 31, 2018 by $67 million related to a remeasurement of certain deferred tax assets and liabilities for which we were unable to make reasonable estimates in 2017. For the year ended, December 31, 2017, a provisional amount of $301 million related to the remeasurement of our deferred tax assets and liabilities for which we were then able to make reasonable estimates was recorded as a component of our provision for income taxes. During 2017 we also reclassified a provisional amount of $127 million from our deferred tax liabilities for the

one-time

transition tax, based on our estimated undistributed post-1986 foreign earnings and profits. Because we had previously recorded U.S. taxes on these earnings, the transition tax liability, which is payable over an

8-year

period, did not affect our 2017 provision for income taxes. Adjustments during 2018 to the provisional amounts recorded in 2017 were not significant.

During 2018, we recorded a reduction to our provision for income taxes of $28 million for tax credits related to certain 2017 hurricane-related expenses. Our provision for income taxes for the years ended December 31, 2019, 2018 and 2017 included tax benefits of $65 million, $124 million and $82 million, respectively, related to the settlement of employee equity awards. Our foreign pretax income was $50 million, $86 million and $91 million for the years ended December 31, 2019, 2018 and 2017, respectively.

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


	2019			2018			2017
Federal statutory rate		21.0	%		21.0	%		35.0	%
State income taxes, net of federal tax benefit		2.7			2.9			2.2
Change in liability for uncertain tax positions		0.4			(0.1	)		—
Tax benefit from settlements of employee equity awards		(1.3	)		(2.4	)		(2.0	)
Impact of Tax Act on deferred tax balances		—			(1.6	)		7.8
Other items, net		1.1			0.2			(0.5	)

Effective income tax rate on income attributable to HCA Healthcare, Inc.		23.9			20.0			42.5
Income attributable to noncontrolling interests from consolidated partnerships		(2.9	)		(2.3	)		(5.1	)

Effective income tax rate on income before income taxes		21.0	%		17.7	%		37.4	%

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


	2019				2018
	Assets		Liabilities		Assets		Liabilities
Depreciation and fixed asset basis differences	$	—	$	601	$	—	$	340
Allowances for professional liability and other risks		376		—		355		—
Accounts receivable		307		—		274		—
Compensation		292		—		256		—
Right-of-use lease assets and obligations		369		366		—		—
Other		461		538		424		491

	$	1,805	$	1,505	$	1,309	$	831

At December 31, 2019, federal and state net operating loss carryforwards (expiring in years

2022

hrough

2038

) available to offset future taxable income approximated $

million and $

128

million, respectively. Utilization of net operating loss carryforwards in any one year may be limited.

The following table summarizes the activity related to our unrecognized tax benefits (dollars in millions):


	2019			2018
Balance at January 1	$	390		$	399
Additions based on tax positions related to the current year		29			22
Additions for tax positions of prior years		119			10
Reductions for tax positions of prior years		(3	)		(14	)
Settlements		—			(2	)
Lapse of applicable statutes of limitations		(13	)		(25	)

Balance at December 31	$	522		$	390

Our liability for unrecognized tax benefits was $550 million, including accrued interest of $62 million and excluding $34 million that was recorded as reductions of the related deferred tax assets, as of December 31, 2019 ($435 million, $48 million and $3 million, respectively, as of December 31, 2018). Unrecognized tax benefits of $160 million ($137 million as of December 31, 2018) would affect the effective rate, if recognized. The increase in our liability for unrecognized tax benefits relates primarily to the effect of certain federal and state legislative and regulatory developments during 2019.

The Internal Revenue Service began an examination of the Company’s 2016 and 2017 federal income tax returns during 2019. We are also subject to examination by state and foreign taxing authorities. Depending on the resolution of any federal, state and foreign tax disputes, the completion of examinations by federal, state or foreign taxing authorities, or the expiration of statutes of limitation for specific taxing jurisdictions, we believe it is reasonably possible that our liability for unrecognized tax benefits may significantly increase or decrease within the next 12 months. However, we are currently unable to estimate the range of any possible change.