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Income Taxes - Schedule of Reconciliation of Federal Statutory Rate to Effective Income Tax Rate (Detail)
12 Months Ended
Dec. 31, 2019
Dec. 31, 2018
Dec. 31, 2017
Income Tax Disclosure [Abstract]      
Federal statutory rate 21.00% 21.00% 35.00%
State income taxes, net of federal tax benefit 2.70% 2.90% 2.20%
Change in liability for uncertain tax positions 0.40% (0.10%)  
Tax benefit from settlements of employee equity awards (1.30%) (2.40%) (2.00%)
Impact of Tax Act on deferred tax balances   (1.60%) 7.80%
Other items, net 1.10% 0.20% (0.50%)
Effective income tax rate on income attributable to HCA Healthcare, Inc. 23.90% 20.00% 42.50%
Income attributable to noncontrolling interests from consolidated partnerships (2.90%) (2.30%) (5.10%)
Effective income tax rate on income before income taxes 21.00% 17.70% 37.40%