Income Taxes (Tables)

12 Months Ended

Dec. 31, 2019

Income Tax Disclosure [Abstract]

Schedule of Provision for Income Taxes

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

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:

	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	%

Schedule of Deferred Tax Assets and Liabilities

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

Schedule of Activity Related to Unrecognized Tax Benefits

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