0001179929-22-000080 | 10-Q | XBRL Viewer

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Cover Page - shares shares in Millions	3 Months Ended
Cover Page - shares shares in Millions	Mar. 31, 2022	Apr. 22, 2022
Cover [Abstract]
Document Type	10-Q
Document Quarterly Report	true
Document Period End Date	Mar. 31, 2022
Document Transition Report	false
Entity File Number	001-31719
Entity Registrant Name	MOLINA HEALTHCARE, INC.
Entity Incorporation, State or Country Code	DE
Entity Tax Identification Number	13-4204626
Entity Address, Address Line One	200 Oceangate
Entity Address, Address Line Two	Suite 100
Entity Address, City or Town	Long Beach,
Entity Address, State or Province	CA
Entity Address, Postal Zip Code	90802
City Area Code	562
Local Phone Number	435-3666
Title of 12(b) Security	Common Stock, $0.001 Par Value
Trading Symbol	MOH
Security Exchange Name	NYSE
Entity Current Reporting Status	Yes
Entity Interactive Data Current	Yes
Entity Filer Category	Large Accelerated Filer
Entity Small Business	false
Entity Emerging Growth Company	false
Entity Shell Company	false
Entity Common Stock, Shares Outstanding		58.7
Entity Central Index Key	0001179929
Current Fiscal Year End Date	--12-31
Document Fiscal Year Focus	2022
Document Fiscal Period Focus	Q1
Amendment Flag	false

CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions	3 Months Ended
CONSOLIDATED STATEMENTS OF INCOME - USD ($) $ in Millions	Mar. 31, 2022	Mar. 31, 2021
Revenue:
Premium revenue	$ 7,531	$ 6,306
Premium tax revenue	208	187
Investment income	11	9
Other revenue	20	20
Total revenue	7,770	6,522
Operating expenses:
Medical care costs	6,563	5,474
General and administrative expenses	571	473
Premium tax expenses	208	187
Depreciation and amortization	40	33
Other	16	20
Total operating expenses	7,398	6,187
Operating income	372	335
Other expenses, net:
Interest expense	28	30
Total other expenses, net	28	30
Income before income tax expense	344	305
Income tax expense	86	77
Net income	$ 258	$ 228
Net income per share:
Net income per share - Basic (in dollars per share)	$ 4.45	$ 3.95
Net income per share - Diluted (in dollars per share)	$ 4.39	$ 3.89

CONSOLIDATED STATEMENTS OF COMPREHENSIVE INCOME - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Statement of Comprehensive Income [Abstract]
Net income	$ 258	$ 228
Other comprehensive loss:
Unrealized investment loss	(100)	(15)
Less: effect of income taxes	(24)	(4)
Other comprehensive loss, net of tax	(76)	(11)
Comprehensive income	$ 182	$ 217

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

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+ Details

CONSOLIDATED BALANCE SHEETS - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Current assets:
Cash and cash equivalents	$ 4,804	$ 4,438
Investments	2,988	3,202
Receivables	2,156	2,177
Prepaid expenses and other current assets	198	247
Total current assets	10,146	10,064
Property, equipment, and capitalized software, net	393	396
Goodwill, and intangible assets, net	1,305	1,252
Restricted investments	221	212
Deferred income taxes	114	106
Other assets	181	179
Total assets	12,360	12,209
Current liabilities:
Medical claims and benefits payable	3,601	3,363
Amounts due government agencies	2,613	2,472
Accounts payable, accrued liabilities and other	809	842
Deferred revenue	18	370
Total current liabilities	7,041	7,047
Long-term debt	2,174	2,173
Finance lease liabilities	217	219
Other long-term liabilities	134	140
Total liabilities	9,566	9,579
Stockholders’ equity:
Common stock, $0.001 par value, 150 million shares authorized; outstanding: 59 million shares at March 31, 2022, and 58 million shares at December 31, 2021	0	0
Preferred stock, $0.001 par value; 20 million shares authorized, no shares issued and outstanding	0	0
Additional paid-in capital	218	236
Accumulated other comprehensive loss	(81)	(5)
Retained earnings	2,657	2,399
Total stockholders’ equity	2,794	2,630
Total liabilities and stockholders’ equity	$ 12,360	$ 12,209

CONSOLIDATED BALANCE SHEETS (Parenthetical) - $ / shares	Mar. 31, 2022	Dec. 31, 2021
Statement of Financial Position [Abstract]
Common stock, par value (in dollars per share)	$ 0.001	$ 0.001
Common stock, shares authorized (in shares)	150,000,000	150,000,000
Common stock, shares outstanding (in shares)	59,000,000	58,000,000
Preferred stock, par value (in dollars per share)	$ 0.001	$ 0.001
Preferred stock, shares authorized (in shares)	20,000,000	20,000,000
Preferred stock, shares issued (in shares)	0	0
Preferred stock, shares outstanding (in shares)	0	0

CONSOLIDATED STATEMENTS OF STOCKHOLDERS' EQUITY - USD ($) shares in Millions, $ in Millions	Total	Common Stock	Additional Paid-in Capital	Accumulated Other Comprehensive Loss	Retained Earnings
Beginning balance (in shares) at Dec. 31, 2020		59
Beginning balance at Dec. 31, 2020	$ 2,096	$ 0	$ 199	$ 37	$ 1,860
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	228				228
Other comprehensive loss, net	(11)			(11)
Common stock purchases (in shares)		(1)
Common stock purchases	(122)		(2)		(120)
Share-based compensation	(27)		(27)
Ending balance (in shares) at Mar. 31, 2021		58
Ending balance at Mar. 31, 2021	2,164	$ 0	170	26	1,968
Beginning balance (in shares) at Dec. 31, 2021		58
Beginning balance at Dec. 31, 2021	2,630	$ 0	236	(5)	2,399
Increase (Decrease) in Stockholders' Equity [Roll Forward]
Net income	258				258
Other comprehensive loss, net	(76)			(76)
Share-based compensation (in shares)		1
Share-based compensation	(18)		(18)
Ending balance (in shares) at Mar. 31, 2022		59
Ending balance at Mar. 31, 2022	$ 2,794	$ 0	$ 218	$ (81)	$ 2,657

- Definition

The portion of profit or loss for the period, net of income taxes, which is attributable to the parent.

+ References

+ Details

- Definition

Total of all stockholders' equity (deficit) items, net of receivables from officers, directors, owners, and affiliates of the entity which are attributable to the parent. The amount of the economic entity's stockholders' equity attributable to the parent excludes the amount of stockholders' equity which is allocable to that ownership interest in subsidiary equity which is not attributable to the parent (noncontrolling interest, minority interest). This excludes temporary equity and is sometimes called permanent equity.

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+ Details

CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Operating activities:
Net income	$ 258	$ 228
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization	40	33
Deferred income taxes	16	6
Share-based compensation	34	24
Other, net	(8)	12
Changes in operating assets and liabilities:
Receivables	21	(98)
Prepaid expenses and other current assets	(32)	(15)
Medical claims and benefits payable	263	168
Amounts due government agencies	137	432
Accounts payable, accrued liabilities and other	(81)	16
Deferred revenue	(352)	(304)
Income taxes	67	66
Net cash provided by operating activities	363	568
Investing activities:
Purchases of investments	(403)	(388)
Proceeds from sales and maturities of investments	513	308
Purchases of property, equipment and capitalized software	(23)	(16)
Other, net	(13)	9
Net cash provided by (used in) investing activities	74	(87)
Financing activities:
Common stock withheld to settle employee tax obligations	(52)	(51)
Contingent consideration liabilities settled	(20)	(20)
Common stock purchases	0	(128)
Other, net	(5)	(8)
Net cash used in financing activities	(77)	(207)
Net increase in cash, cash equivalents, and restricted cash and cash equivalents	360	274
Cash, cash equivalents, and restricted cash and cash equivalents at beginning of period	4,506	4,223
Cash, cash equivalents, and restricted cash and cash equivalents at end of period	$ 4,866	$ 4,497

Organization and Basis of Presentation	3 Months Ended
Organization and Basis of Presentation	Mar. 31, 2022
Organization, Consolidation and Presentation of Financial Statements [Abstract]
Organization and Basis of Presentation	Organization and Basis of Presentation Organization and Operations Molina Healthcare, Inc. provides managed healthcare services under the Medicaid and Medicare programs, and through the state insurance marketplaces (the “Marketplace”). We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve. As of March 31, 2022, we served approximately 5.1 million members eligible for government-sponsored healthcare programs, located across 19 states. Our state Medicaid contracts typically have terms of three to five years, contain renewal options exercisable by the state Medicaid agency, and allow either the state or the health plan to terminate the contract with or without cause. Such contracts are subject to risk of loss in states that issue requests for proposal (“RFPs”) open to competitive bidding by other health plans. If one of our health plans is not a successful responsive bidder to a state RFP, its contract may not be renewed. In addition to contract renewal, our state Medicaid contracts may be periodically amended to include or exclude certain health benefits (such as pharmacy services, behavioral health services, or long-term care services); populations such as the aged, blind or disabled (“ABD”); and regions or service areas. Recent Developments California Procurement—Medicaid. In April 2022, we submitted our RFP response. We expect the award to be announced in early August 2022, with an effective date of January 2024. Texas Procurement—Medicaid. In March 2022, the Texas Health and Human Services Commission posted the ABD program (known in Texas as STAR+PLUS) RFP, with awards estimated to be announced in the fourth quarter of 2022, and start of operations in September 2023. Texas Acquisition—Medicaid and Medicare. On January 1, 2022, we closed on our acquisition of Cigna Corporation’s Texas Medicaid and Medicare-Medicaid Plan (“MMP”) contracts, along with certain operating assets. See Note 4, “Business Combinations,” for further information. Nevada Procurement—Medicaid. Our new contract in Clark and Washoe Counties commenced on January 1, 2022, and offers health coverage to TANF, CHIP and Medicaid Expansion beneficiaries. The four year contract with a possible two-year extension was ratified in September 2021. Consolidation and Interim Financial Information The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the interim periods presented have been included; such adjustments consist of normal recurring adjustments. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the three months ended March 31, 2022 are not necessarily indicative of the results for the entire year ending December 31, 2022. The unaudited consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read or have access to our audited consolidated financial statements for the fiscal year ended December 31, 2021. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2021, audited consolidated financial statements have been omitted. These unaudited consolidated interim financial statements should be read in conjunction with our audited consolidated financial statements for the fiscal year ended December 31, 2021. Use of Estimates The preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates.

Significant Accounting Policies

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Significant Accounting Policies

Cash and Cash Equivalents

Cash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase. The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.


	March 31,
	2022		2021

	(In millions)
Cash and cash equivalents	$	4,804	$	4,431
Restricted cash and cash equivalents	62		66
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	4,866	$	4,497

Receivables

Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made.


	March 31, 2022		December 31, 2021

	(In millions)
Government receivables	$	1,589	$	1,566
Pharmacy rebate receivables	306		276

Other	261		335

Total	$	2,156	$	2,177

Premium Revenue Recognition and Amounts Due Government Agencies

Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the Medicaid, Medicare, and Marketplace programs. Premium revenue is generally received based on per member per month (“PMPM”) rates established in advance of the periods covered. These premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. State Medicaid programs and the federal Medicare program periodically adjust premium rates.

Certain components of premium revenue are subject to accounting estimates and are described in further detail below, and in our 2021 Annual Report on Form 10-K, Note 2, “Significant Accounting Policies,” under “Contractual Provisions That May Adjust or Limit Revenue or Profit,” and “Quality Incentives.”

Contractual Provisions That May Adjust or Limit Revenue or Profit

Many of our contracts contain provisions that may adjust or limit revenue or profit, as described below. Consequently, we recognize premium revenue as it is earned under such provisions. Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies,” in the accompanying consolidated balance sheets.

The following table sets forth amounts due government agencies, categorized by program:


	March 31, 2022		December 31, 2021

	(In millions)
Medicaid program:
Minimum MLR and profit sharing	$	1,033	$	1,016
Other	270		263
Medicare program:
Risk adjustment and Part D risk sharing	105		89
Minimum MLR and profit sharing	103		101
Other	31		35
Marketplace program:
Risk adjustment	949		902
Minimum MLR	20		18
Other	102		48

Total amounts due government agencies	$	2,613	$	2,472

Medicaid Program

Minimum MLR and Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted.

Beginning in 2020, various states enacted temporary risk corridors in response to the reduced demand for medical services stemming from COVID-19, which have resulted in a reduction of our medical margin. In some cases, these risk corridors were retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. Beginning in the second quarter of 2020, we have recognized risk corridors that we believe to be probable, and where the ultimate premium amount is reasonably estimable. For the three months ended March 31, 2022, we recognized approximately $28 million related to such risk corridors, primarily in the Medicaid segment, compared to $110 million recognized in the three months ended March 31, 2021. The decrease is due to the elimination of several of the COVID-19 risk corridors.

It is possible that certain states could change the structure of existing risk corridors, implement new risk corridors in the future or discontinue existing risk corridors. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a result of changes in facts or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows.

Marketplace Program

Risk Adjustment. Under this program, our health plans’ composite risk scores are compared with the overall average risk score for the relevant state and market pool. Generally, our health plans will make a risk adjustment payment into the pool if their composite risk scores are below the average risk score (risk adjustment payable), and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score (risk adjustment receivable). We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income. As of March 31, 2022, Marketplace risk adjustment payables amounted to $949 million and related receivables amounted to $33 million, for a net payable of $916 million. As of December 31, 2021, Marketplace risk adjustment payables amounted to $902 million and related receivables amounted to $7 million, for a net payable of $895 million.

Concentrations of Credit Risk

Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. Our investments consist primarily of investment-grade debt securities with final maturities of less than 15 years, or less than 15 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the federal government, and governments of each state in which our health plan subsidiaries operate.

Income Taxes

The provision for income taxes is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of foreign and state taxes, and nondeductible expenses such as certain compensation and other general and administrative expenses.

The effective tax rate may be subject to fluctuations during the year as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including projected pretax earnings, the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers.

Recent Accounting Pronouncements

Recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, and the Securities and Exchange Commission (“SEC”) did not have, nor does management expect such pronouncements to have, a significant impact on our present or future consolidated financial statements.

Net Income Per Share

3 Months Ended

Mar. 31, 2022

Earnings Per Share [Abstract]

Net Income Per Share

The following table sets forth the calculation of basic and diluted net income per share:


	Three Months Ended March 31,
	2022		2021

	(In millions, except net income per share)
Numerator:
Net income	$	258	$	228
Denominator:
Shares outstanding at the beginning of the period	57.9		58.0
Weighted-average number of shares issued:
Stock-based compensation	0.1		0.1
Stock purchases	—		(0.4)
Denominator for basic net income per share	58.0		57.7
Effect of dilutive securities: (1)
Stock-based compensation	0.7		0.9

Denominator for diluted net income per share	58.7		58.6

Net income per share - Basic (2)	$	4.45	$	3.95
Net income per share - Diluted (2)	$	4.39	$	3.89

______________________________

(1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method.

(2) Source data for calculations in thousands.

Business Combinations	3 Months Ended
Business Combinations	Mar. 31, 2022
Business Combination and Asset Acquisition [Abstract]
Business Combinations	Business CombinationsCigna. On January 1, 2022, we closed on our acquisition of Cigna Corporation’s Texas Medicaid and Medicare-Medicaid Plan contracts, along with certain operating assets, for purchase consideration of approximately $60 million. We acquired membership and a provider network with a preliminary fair value of approximately $36 million. We allocated the remaining $24 million of purchase consideration to goodwill, primarily in the Medicaid segment, which relates to future economic benefits arising from expected synergies from the use of our existing infrastructure to support the added membership, and from the assembled workforce. The goodwill is deductible for income tax purposes. Affinity. On October 25, 2021, we closed on our acquisition of substantially all of the assets of Affinity Health Plan, Inc., a Medicaid health plan in New York, for initial purchase consideration of approximately $176 million. In the three months ended March 31, 2022, we recorded various measurement period adjustments, including a decrease of $25 million to “Medical claims and benefits payable,” and an increase of $4 million to “Amounts due government agencies.” In the aggregate, we recorded a net increase of $11 million to goodwill for these measurement period adjustments and various purchase price adjustments.

Fair Value Measurements

3 Months Ended

Mar. 31, 2022

Fair Value Disclosures [Abstract]

Fair Value Measurements

We consider the carrying amounts of current assets and current liabilities to approximate their fair values because of the relatively short period of time between the origination of these instruments and their expected realization or payment. For our financial instruments measured at fair value on a recurring basis, we prioritize the inputs used in measuring fair value according to the three-tier fair value hierarchy. For a description of the methods and assumptions used to: a) estimate the fair value; and b) determine the classification according to the fair value hierarchy for each financial instrument, refer to our 2021 Annual Report on Form 10-K, Note 5, “Fair Value Measurements.”

The net changes in fair value of Level 3 financial instruments are reported in “Other” operating expenses in our consolidated statements of income. In the three months ended March 31, 2022 and 2021, we recognized a loss of $4 million and $8 million, respectively, for the increase in the fair value of the contingent consideration liabilities described below.

Our financial instruments measured at fair value on a recurring basis at March 31, 2022, were as follows:


			Observable Inputs		Directly or Indirectly Observable Inputs		Unobservable Inputs
	Total		(Level 1)		(Level 2)		(Level 3)

	(In millions)
Corporate debt securities	$	1,808	$	—	$	1,808	$	—
Mortgage-backed securities	598		—		598		—
Asset-backed securities	252		—		252		—
U.S. Treasury notes	174		—		174		—
Municipal securities	117		—		117		—



Other	39		—		39		—
Total assets	$	2,988	$	—	$	2,988	$	—

Contingent consideration liabilities	$	8	$	—	$	—	$	8
Total liabilities	$	8	$	—	$	—	$	8

Our financial instruments measured at fair value on a recurring basis at December 31, 2021, were as follows:


			Observable Inputs		Directly or Indirectly Observable Inputs		Unobservable Inputs
	Total		(Level 1)		(Level 2)		(Level 3)

	(In millions)
Corporate debt securities	$	1,833	$	—	$	1,833	$	—
Mortgage-backed securities	614		—		614		—
Asset-backed securities	247		—		247		—
U.S. Treasury notes	353		—		353		—
Municipal securities	123		—		123		—


Other	32		—		32		—
Total assets	$	3,202	$	—	$	3,202	$	—

Contingent consideration liabilities	$	47	$	—	$	—	$	47
Total liabilities	$	47	$	—	$	—	$	47

Contingent Consideration Liabilities

Our Level 3 financial instruments at March 31, 2022 are comprised solely of contingent consideration liabilities of $8 million, in connection with our 2020 acquisition of certain assets of Passport Health Plan, Inc., a Medicaid health plan in Kentucky. Such liabilities are recorded at fair value on a recurring basis. In the three months ended March 31, 2022, the estimated fair value of contingent purchase consideration increased by approximately $4 million, relating to an operating income guarantee.

In the three months ended March 31, 2022 we paid the seller $43 million, of which $23 million was for the remaining half of the consideration due for minimum member enrollment targets and $20 million was for the first payment of the consideration due for the operating income guarantee. For the amounts paid in the three months ended March 31, 2022, $20 million has been presented in “Financing activities” in the accompanying consolidated statements of cash flows, with the balance reflected in “Operating activities.” The remaining balance of the liabilities is reported in “Accounts payable, accrued liabilities and other” in the accompanying consolidated balance sheets.

Fair Value Measurements – Disclosure Only

The carrying amounts and estimated fair values of our notes payable are classified as Level 2 financial instruments. Fair value for these securities is determined using a market approach based on quoted market prices for similar securities in active markets or quoted prices for identical securities in inactive markets.


	March 31, 2022				December 31, 2021
	Carrying Amount		Fair Value		Carrying Amount		Fair Value

	(In millions)
4.375% Notes due 2028	$	791	$	789	$	791	$	829
3.875% Notes due 2030	642		624		642		675
3.875% Notes due 2032	741		713		740		760
Total	$	2,174	$	2,126	$	2,173	$	2,264

- Definition

The entire disclosure for the fair value of financial instruments (as defined), including financial assets and financial liabilities (collectively, as defined), and the measurements of those instruments as well as disclosures related to the fair value of non-financial assets and liabilities. Such disclosures about the financial instruments, assets, and liabilities would include: (1) the fair value of the required items together with their carrying amounts (as appropriate); (2) for items for which it is not practicable to estimate fair value, disclosure would include: (a) information pertinent to estimating fair value (including, carrying amount, effective interest rate, and maturity, and (b) the reasons why it is not practicable to estimate fair value; (3) significant concentrations of credit risk including: (a) information about the activity, region, or economic characteristics identifying a concentration, (b) the maximum amount of loss the entity is exposed to based on the gross fair value of the related item, (c) policy for requiring collateral or other security and information as to accessing such collateral or security, and (d) the nature and brief description of such collateral or security; (4) quantitative information about market risks and how such risks are managed; (5) for items measured on both a recurring and nonrecurring basis information regarding the inputs used to develop the fair value measurement; and (6) for items presented in the financial statement for which fair value measurement is elected: (a) information necessary to understand the reasons for the election, (b) discussion of the effect of fair value changes on earnings, (c) a description of [similar groups] items for which the election is made and the relation thereof to the balance sheet, the aggregate carrying value of items included in the balance sheet that are not eligible for the election; (7) all other required (as defined) and desired information.

+ References + Details

Investments

3 Months Ended

Mar. 31, 2022

Investments, Debt and Equity Securities [Abstract]

Investments

Available-for-Sale

We consider all of our investments classified as current assets to be available-for-sale. The following tables summarize our current investments as of the dates indicated:


	March 31, 2022
	Amortized Cost		Gross Unrealized				Estimated Fair Value
			Gains		Losses

	(In millions)
Corporate debt securities	$	1,874	$	1	$	67	$	1,808
Mortgage-backed securities	622		—		24		598
Asset-backed securities	261		—		9		252
U.S. Treasury notes	174		—		—		174
Municipal securities	123		—		6		117



Other	40		—		1		39
Total	$	3,094	$	1	$	107	$	2,988


	December 31, 2021
	Amortized Cost		Gross Unrealized				Estimated Fair Value
			Gains		Losses

	(In millions)
Corporate debt securities	$	1,836	$	9	$	12	$	1,833
Mortgage-backed securities	616		2		4		614
Asset-backed securities	248		—		1		247
U.S. Treasury notes	353		—		—		353
Municipal securities	123		1		1		123


Other	32		—		—		32
Total	$	3,208	$	12	$	18	$	3,202

The contractual maturities of our current investments as of March 31, 2022 are summarized below:


	Amortized Cost		Estimated Fair Value

	(In millions)
Due in one year or less	$	466	$	466
Due after one year through five years	1,733		1,668
Due after five years through ten years	318		306
Due after ten years	577		548
Total	$	3,094	$	2,988

Gross realized gains and losses from sales of available-for-sale securities are calculated under the specific identification method and are included in investment income. Gross realized investment gains and losses were insignificant for the three months ended March 31, 2022, and 2021.

We have determined that unrealized losses at March 31, 2022, and December 31, 2021, primarily resulted from fluctuating interest rates, rather than a deterioration of the creditworthiness of the issuers. Therefore, we determined that an allowance for credit losses was not necessary. So long as we maintain the intent and ability to hold these securities to maturity, we are unlikely to experience losses. In the event that we dispose of these securities before maturity, we expect that realized losses, if any, will be insignificant.

The following table summarizes those available-for-sale investments that have been in a continuous loss position for less than 12 months. No investments have been in a continuous loss position for 12 months or more as of March 31, 2022, and December 31, 2021.


	March 31, 2022					December 31, 2021
	Estimated Fair Value		Unrealized Losses		Total Number of Positions	Estimated Fair Value		Unrealized Losses		Total Number of Positions

	(Dollars in millions)
Corporate debt securities	$	1,516	$	67	624	$	1,063	$	12	395
Mortgage-backed securities	582		24		238	408		4		146
Asset-backed securities	208		9		99	166		1		75

Municipal securities	97		6		120	69		1		61
Other	25		1		10	—		—		—



Total	$	2,428	$	107	1,091	$	1,706	$	18	677

Restricted Investments Held-to-Maturity

Pursuant to the regulations governing our state health plan subsidiaries, we maintain statutory deposits and deposits required by government authorities primarily in cash, cash equivalents, and U.S. Treasury securities. We also maintain restricted investments as protection against the insolvency of certain capitated providers. The use of these funds is limited as required by regulations in the various states in which we operate, or as needed in the event of insolvency of capitated providers. Therefore, such investments are reported as “Restricted investments” in the accompanying consolidated balance sheets.

We have the ability to hold these restricted investments until maturity, and as a result, we would not expect the value of these investments to decline significantly due to a sudden change in market interest rates. Our held-to-maturity restricted investments are carried at amortized cost, which approximates fair value. Such investments amounted to $221 million at March 31, 2022, of which $190 million will mature in one year or less, and $31 million will mature in one through five years.

Medical Claims and Benefits Payable

3 Months Ended

Mar. 31, 2022

Other Liabilities Disclosure [Abstract]

Medical Claims and Benefits Payable

The following table provides the details of our medical claims and benefits payable as of the dates indicated:


	March 31, 2022		December 31, 2021

	(In millions)
Claims incurred but not paid (“IBNP”)	$	2,521	$	2,486
Pharmacy payable	240		219
Capitation payable	95		82
Other	745		576
Total	$	3,601	$	3,363

“Other” medical claims and benefits payable include amounts payable to certain providers for which we act as an intermediary on behalf of various government agencies without assuming financial risk. Such receipts and payments do not impact our consolidated statements of income. Non-risk provider payables amounted to $322 million and $226 million as of March 31, 2022, and December 31, 2021, respectively.

The following tables present the components of the change in our medical claims and benefits payable for the periods indicated. The amounts presented for “Components of medical care costs related to: Prior years” represent the amount by which our original estimate of medical claims and benefits payable at the beginning of the year varied from the actual liabilities, based on information (principally the payment of claims) developed since those liabilities were first reported.


	Three Months Ended March 31, 2022
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,580	$	404	$	379	$	3,363
Components of medical care costs related to:
Current year	5,424		840		505		6,769
Prior years	(154)		(25)		(27)		(206)
Total medical care costs	5,270		815		478		6,563
Payments for medical care costs related to:
Current year	3,402		465		330		4,197
Prior years	1,633		306		260		2,199
Total paid	5,035		771		590		6,396
Acquired balances, net of post-acquisition adjustments	(25)		—		—		(25)
Change in non-risk and other provider payables	93		3		—		96
Medical claims and benefits payable, ending balance	$	2,883	$	451	$	267	$	3,601


	Three Months Ended March 31, 2021
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,129	$	392	$	175	$	2,696
Components of medical care costs related to:
Current year	4,394		738		536		5,668
Prior years	(158)		(16)		(20)		(194)
Total medical care costs	4,236		722		516		5,474
Payments for medical care costs related to:
Current year	2,790		410		313		3,513
Prior years	1,364		304		113		1,781
Total paid	4,154		714		426		5,294
Acquired balances, net of post-acquisition adjustments	8		(33)		—		(25)
Change in non-risk and other provider payables	(11)		(1)		—		(12)
Medical claims and benefits payable, ending balance	$	2,208	$	366	$	265	$	2,839

Our estimates of medical claims and benefits payable recorded at December 31, 2021, and 2020 developed favorably by approximately $206 million and $194 million as of March 31, 2022, and 2021, respectively.

The favorable prior year development recognized in the three months ended March 31, 2022 was primarily due to lower than expected utilization of medical services by our members and improved operating performance. Consequently, the ultimate costs recognized in 2022, as claims payments were processed, were lower than our estimates in 2021.

Debt

3 Months Ended

Mar. 31, 2022

Debt Disclosure [Abstract]

Debt

All our debt is held at the parent, which is reported in the Other segment. The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below:


	March 31, 2022		December 31, 2021

	(In millions)




Non-current long-term debt:
4.375% Notes due 2028	$	800	$	800
3.875% Notes due 2030	650		650
3.875% Notes due 2032	750		750
Deferred debt issuance costs	(26)		(27)
Total	$	2,174	$	2,173

Credit Agreement

We are party to a credit agreement (the “Credit Agreement”) which includes a revolving credit facility (“Credit Facility”) of $1.0 billion, among other provisions. The Credit Agreement has a term of five years, and all amounts outstanding will be due and payable on June 8, 2025. Borrowings under the Credit Agreement bear interest based, at our election, on a base rate or other defined rate, plus in each case, the applicable margin. In addition to interest payable on the principal amount of indebtedness outstanding from time to time under the Credit Agreement, we are required to pay a quarterly commitment fee.

The Credit Agreement contains customary non-financial and financial covenants. As of March 31, 2022, we were in compliance with all financial and non-financial covenants under the Credit Agreement and other long-term debt. As of March 31, 2022, no amounts were outstanding under the Credit Facility.

Senior Notes

Our senior notes are described below. Each of these notes are senior unsecured obligations of Molina and rank equally in right of payment with all existing and future senior debt, and senior to all existing and future subordinated debt of Molina. In addition, each of the notes contain customary non-financial covenants and change of control provisions.

The indentures governing the senior notes contain cross-default provisions that are triggered upon default by us or any of our subsidiaries on any indebtedness in excess of the amount specified in the applicable indenture.

4.375% Notes due 2028. We had $800 million aggregate principal amount of senior notes (the “4.375% Notes”) outstanding as of March 31, 2022, which are due June 15, 2028, unless earlier redeemed. Interest, at a rate of 4.375% per annum, is payable semiannually in arrears on June 15 and December 15.

3.875% Notes due 2030. We had $650 million aggregate principal amount of senior notes (the “3.875% Notes due 2030”) outstanding as of March 31, 2022, which are due November 15, 2030, unless earlier redeemed. Interest, at a rate of 3.875% per annum, is payable semiannually in arrears on May 15 and November 15.

3.875% Notes due 2032. We had $750 million aggregate principal amount of senior notes (the “3.875% Notes due 2032”) outstanding as of March 31, 2022, which are due May 15, 2032, unless earlier redeemed. Interest, at a rate of 3.875% per annum, is payable semiannually in arrears on May 15 and November 15.

Stockholders' Equity	3 Months Ended
Stockholders' Equity	Mar. 31, 2022
Equity [Abstract]
Stockholders' Equity	Stockholders' Equity In September 2021, our board of directors authorized the purchase of up to $500 million, in the aggregate, of our common stock. This new program, which superseded the stock purchase program approved by our board of directors in September 2020, is funded with cash on hand and extends through December 31, 2022. The exact timing and amount of any repurchase is determined by management based on market conditions and share price, in addition to other factors, and subject to the restrictions relating to volume, price, and timing under applicable law. As of April 27, 2022, we have purchased 85,000 shares under the stock purchase program approved in 2021.

- Definition

The entire disclosure for shareholders' equity comprised of portions attributable to the parent entity and noncontrolling interest, including other comprehensive income. Includes, but is not limited to, balances of common stock, preferred stock, additional paid-in capital, other capital and retained earnings, accumulated balance for each classification of other comprehensive income and amount of comprehensive income.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 13: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Segments

3 Months Ended

Mar. 31, 2022

Segment Reporting [Abstract]

Segments

We currently have four reportable segments consisting of: 1) Medicaid; 2) Medicare; 3) Marketplace; and 4) Other. Our reportable segments are consistent with how we currently manage the business and view the markets we serve.

The Medicaid, Medicare, and Marketplace segments represent the government-funded or sponsored programs under which we offer managed healthcare services. The Other segment, which is insignificant to our consolidated results of operations, includes certain corporate amounts not associated with or allocated to the Medicaid, Medicare, or Marketplace segments. Additionally, the Other segment includes service revenues and service costs associated with the long-term services and supports consultative services we provide in Wisconsin.

The key metrics used to assess the performance of our Medicaid, Medicare, and Marketplace segments are premium revenue, medical margin and medical care ratio (“MCR”). MCR represents the amount of medical care costs as a percentage of premium revenue. Therefore, the underlying medical margin, or the amount earned by the Medicaid, Medicare, and Marketplace segments after medical costs are deducted from premium revenue, represents the most important measure of earnings reviewed by management, and is used by our chief executive officer to review results, assess performance, and allocate resources. The key metric used to assess the performance of our Other segment is service margin. The service margin is equal to service revenue minus cost of service revenue. We do not report total assets by segment because this is not a metric used to assess segment performance or allocate resources.

The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented.


	Three Months Ended March 31,
	2022		2021

	(In millions)
Total revenue:
Medicaid	$	6,187	$	5,020
Medicare	949		805
Marketplace	616		680
Other	18		17
Total	$	7,770	$	6,522

The following table reconciles margin by segment to consolidated income before income taxes.


	Three Months Ended March 31,
	2022		2021

	(In millions)
Margin:
Medicaid	$	710	$	604
Medicare	128		77
Marketplace	130		151
Other	3		4
Total margin	971		836
Add: other operating revenues (1)	221		199
Less: other operating expenses (2)	(820)		(700)
Operating income	372		335
Other expenses, net	28		30
Income before income tax expense	$	344	$	305

______________________

(1)Other operating revenues include premium tax revenue, investment income, and other revenue.

(2)Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and other operating expenses.

- Definition

The entire disclosure for reporting segments including data and tables. Reportable segments include those that meet any of the following quantitative thresholds a) it's reported revenue, including sales to external customers and intersegment sales or transfers is 10 percent or more of the combined revenue, internal and external, of all operating segments b) the absolute amount of its reported profit or loss is 10 percent or more of the greater, in absolute amount of 1) the combined reported profit of all operating segments that did not report a loss or 2) the combined reported loss of all operating segments that did report a loss c) its assets are 10 percent or more of the combined assets of all operating segments.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
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+ Details

Commitments and Contingencies	3 Months Ended
Commitments and Contingencies	Mar. 31, 2022
Commitments and Contingencies Disclosure [Abstract]
Commitments and Contingencies	Commitments and Contingencies COVID-19 Pandemic We continue to monitor and assess the estimated operating and financial impact of the COVID-19 pandemic, and as it evolves, we continue to process, assemble, and assess member utilization information. We believe that our cash resources, borrowing capacity available under the Credit Agreement, and cash flow generated from operations will be sufficient to withstand the financial impact of the pandemic, and will enable us to continue to support our operations, regulatory requirements, debt repayment obligations, and capital expenditures for the foreseeable future. Legal Proceedings The healthcare industry is subject to numerous laws and regulations of federal, state, and local governments. Compliance with these laws and regulations can be subject to government review and interpretation, as well as regulatory actions unknown and unasserted at this time. Penalties associated with violations of these laws and regulations include significant fines and penalties, exclusion from participating in publicly funded programs, the repayment of previously billed and collected revenues and reputational damage. We are involved in legal actions in the ordinary course of business including, but not limited to, various employment claims, vendor disputes and provider claims. Some of these legal actions seek monetary damages, including claims for punitive damages, which may not be covered by insurance. We review legal matters and update our estimates of reasonably possible losses and related disclosures, as necessary. We have accrued liabilities for legal matters for which we deem the loss to be both probable and reasonably estimable. These liability estimates could change as a result of further developments of the matters. The outcome of legal actions is inherently uncertain. An adverse determination in one or more of these pending matters could have an adverse effect on our consolidated financial position, results of operations, or cash flows. Kentucky RFP. On September 4, 2020, Anthem Kentucky Managed Care Plan, Inc. brought an action in Franklin County Circuit Court against the Kentucky Finance and Administration Cabinet, the Kentucky Cabinet for Health and Family Services, and all of the five winning bidder health plans, including our Kentucky health plan. The appellate briefing has concluded and no assurances can be given regarding the ultimate outcome. Under the Court’s June 16, 2021 final Order, our Kentucky health plan will continue to operate for the foreseeable future under its current Medicaid contract and provide care to Kentucky Medicaid members. Puerto Rico. On August 13, 2021, Molina Healthcare of Puerto Rico, Inc. (“MHPR”) filed a complaint asserting, among other claims, breach of contract against the Puerto Rico Health Insurance Administration (“ASES”). On September 13, 2021, in addition to filing its answer to MHPR’s complaint, ASES filed a counterclaim and a third-party complaint against MHPR and the Company. The counterclaim alleges that MHPR and the Company breached contractual obligations by failing to pay providers, and seeks damages and various equitable remedies. On October 8, 2021, MHPR filed its reply to the counterclaim, denying all the allegations, and on November 1, 2021, the Company filed its answer to the third-party complaint. On December 3, 2021, MHPR filed a request for disbursement of illegally withheld funds, and ASES filed its opposition. At a status hearing on January 19, 2022, the Court heard MHPR’s request for disbursement. The Court has not ruled on the request. On March 23, 2022, the Court informed the parties that it will appoint a Special Commissioner to review the merits of the entire case, with the assigned judge retaining final authority over any resolution. The parties are negotiating the engagement of the Special Commissioner. This matter is in its early stages and remains subject to significant additional proceedings, and no prediction can be made as to the outcome. No gain or loss is probable and reasonably estimable with regard to either MHPR’s complaint or the counterclaim of ASES.

Significant Accounting Policies (Policies)	3 Months Ended
Significant Accounting Policies (Policies)	Mar. 31, 2022
Accounting Policies [Abstract]
Consolidation and Interim Financial Information	Consolidation and Interim Financial Information The consolidated financial statements include the accounts of Molina Healthcare, Inc., and its subsidiaries. In the opinion of management, all adjustments considered necessary for a fair presentation of the results as of the date and for the interim periods presented have been included; such adjustments consist of normal recurring adjustments. All significant intercompany balances and transactions have been eliminated. The consolidated results of operations for the three months ended March 31, 2022 are not necessarily indicative of the results for the entire year ending December 31, 2022. The unaudited consolidated interim financial statements have been prepared under the assumption that users of the interim financial data have either read or have access to our audited consolidated financial statements for the fiscal year ended December 31, 2021. Accordingly, certain disclosures that would substantially duplicate the disclosures contained in our December 31, 2021, audited consolidated financial statements have been omitted. These unaudited consolidated interim financial statements should be read in conjunction with our audited consolidated financial statements for the fiscal year ended December 31, 2021.
Use of Estimates	Use of EstimatesThe preparation of consolidated financial statements in conformity with U.S. generally accepted accounting principles (“GAAP”) requires management to make estimates and assumptions that affect the reported amounts of assets and liabilities. Estimates also affect the reported amounts of revenues and expenses during the reporting period. Actual results could differ from these estimates.
Cash and Cash Equivalents	Cash and Cash EquivalentsCash and cash equivalents consist of cash and short-term, highly liquid investments that are both readily convertible into known amounts of cash and have a maturity of three months or less on the date of purchase.
Receivables	Receivables Receivables consist primarily of premium amounts due from government agencies, which are subject to potential retroactive adjustments. Because substantially all of our receivable amounts are readily determinable and substantially all of our creditors are governmental authorities, our allowance for credit losses is insignificant. Any amounts determined to be uncollectible are charged to expense when such determination is made.
Premium Revenue Recognition and Amounts Due Government Agencies and Contractual Provisions That May Adjust or Limit Revenue or Profit	Premium Revenue Recognition and Amounts Due Government Agencies Premium revenue is generated from our contracts with state and federal agencies, in connection with our participation in the Medicaid, Medicare, and Marketplace programs. Premium revenue is generally received based on per member per month (“PMPM”) rates established in advance of the periods covered. These premium revenues are recognized in the month that members are entitled to receive healthcare services, and premiums collected in advance are deferred. State Medicaid programs and the federal Medicare program periodically adjust premium rates. Certain components of premium revenue are subject to accounting estimates and are described in further detail below, and in our 2021 Annual Report on Form 10-K, Note 2, “Significant Accounting Policies,” under “Contractual Provisions That May Adjust or Limit Revenue or Profit,” and “Quality Incentives.” Contractual Provisions That May Adjust or Limit Revenue or ProfitMany of our contracts contain provisions that may adjust or limit revenue or profit, as described below. Consequently, we recognize premium revenue as it is earned under such provisions. Medicaid Program Minimum MLR and Retroactive Premium Adjustments. State Medicaid programs periodically adjust premium rates on a retroactive basis. In these cases, we adjust our premium revenue in the period in which we determine that the adjustment is probable and reasonably estimable, based on our best estimate of the ultimate premium we expect to realize for the period being adjusted. Beginning in 2020, various states enacted temporary risk corridors in response to the reduced demand for medical services stemming from COVID-19, which have resulted in a reduction of our medical margin. In some cases, these risk corridors were retroactive to earlier periods in 2020, or as early as the beginning of the states’ fiscal years in 2019. Beginning in the second quarter of 2020, we have recognized risk corridors that we believe to be probable, and where the ultimate premium amount is reasonably estimable. For the three months ended March 31, 2022, we recognized approximately $28 million related to such risk corridors, primarily in the Medicaid segment, compared to $110 million recognized in the three months ended March 31, 2021. The decrease is due to the elimination of several of the COVID-19 risk corridors. It is possible that certain states could change the structure of existing risk corridors, implement new risk corridors in the future or discontinue existing risk corridors. Due to these uncertainties, the ultimate outcomes could differ materially from our estimates as a result of changes in facts or further developments, which could have an adverse effect on our consolidated financial position, results of operations, or cash flows. Marketplace Program Risk Adjustment. Under this program, our health plans’ composite risk scores are compared with the overall average risk score for the relevant state and market pool. Generally, our health plans will make a risk adjustment payment into the pool if their composite risk scores are below the average risk score (risk adjustment payable), and will receive a risk adjustment payment from the pool if their composite risk scores are above the average risk score (risk adjustment receivable). We estimate our ultimate premium based on insurance policy year-to-date experience, and recognize estimated premiums relating to the risk adjustment program as an adjustment to premium revenue in our consolidated statements of income.
Concentrations of Credit Risk	Concentrations of Credit Risk Financial instruments that potentially subject us to concentrations of credit risk consist primarily of cash and cash equivalents, investments, receivables, and restricted investments. Our investments and a portion of our cash equivalents are managed by professional portfolio managers operating under documented investment guidelines. Our portfolio managers must obtain our prior approval before selling investments where the loss position of those investments exceeds certain levels. Our investments consist primarily of investment-grade debt securities with final maturities of less than 15 years, or less than 15 years average life for structured securities. Restricted investments are invested principally in cash, cash equivalents, and U.S. Treasury securities. Concentration of credit risk with respect to accounts receivable is limited because our payors consist principally of the federal government, and governments of each state in which our health plan subsidiaries operate.
Income Taxes	Income Taxes The provision for income taxes is determined using an estimated annual effective tax rate, which generally differs from the U.S. federal statutory rate primarily because of foreign and state taxes, and nondeductible expenses such as certain compensation and other general and administrative expenses. The effective tax rate may be subject to fluctuations during the year as new information is obtained. Such information may affect the assumptions used to estimate the annual effective tax rate, including projected pretax earnings, the mix of pretax earnings in the various tax jurisdictions in which we operate, valuation allowances against deferred tax assets, the recognition or the reversal of the recognition of tax benefits related to uncertain tax positions, and changes in or the interpretation of tax laws in jurisdictions where we conduct business. We recognize deferred tax assets and liabilities for temporary differences between the financial reporting basis and the tax basis of our assets and liabilities, along with net operating loss and tax credit carryovers.
Recent Accounting Pronouncements	Recent Accounting Pronouncements Recent accounting pronouncements issued by the FASB (including its Emerging Issues Task Force), the American Institute of Certified Public Accountants, and the Securities and Exchange Commission (“SEC”) did not have, nor does management expect such pronouncements to have, a significant impact on our present or future consolidated financial statements.

- Definition

Disclosure of accounting policy for income taxes, which may include its accounting policies for recognizing and measuring deferred tax assets and liabilities and related valuation allowances, recognizing investment tax credits, operating loss carryforwards, tax credit carryforwards, and other carryforwards, methodologies for determining its effective income tax rate and the characterization of interest and penalties in the financial statements.

+ References + Details

- Definition

Disclosure of accounting policy for revenue from contract with customer.

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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+ Details

Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2022

Accounting Policies [Abstract]

Schedule of Cash and cash equivalents

The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the accompanying consolidated balance sheets that sum to the total of the same such amounts presented in the accompanying consolidated statements of cash flows. The restricted cash and cash equivalents presented below are included in “Restricted investments” in the accompanying consolidated balance sheets.


	March 31,
	2022		2021

	(In millions)
Cash and cash equivalents	$	4,804	$	4,431
Restricted cash and cash equivalents	62		66
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	4,866	$	4,497

Schedule of Restricted Cash and Cash Equivalents


	March 31,
	2022		2021

	(In millions)
Cash and cash equivalents	$	4,804	$	4,431
Restricted cash and cash equivalents	62		66
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$	4,866	$	4,497

Schedule of Receivables


	March 31, 2022		December 31, 2021

	(In millions)
Government receivables	$	1,589	$	1,566
Pharmacy rebate receivables	306		276

Other	261		335

Total	$	2,156	$	2,177

Schedule of Amounts Due to Government Agencies

Liabilities accrued for premiums to be returned under such provisions are reported in the aggregate as “Amounts due government agencies,” in the accompanying consolidated balance sheets.

The following table sets forth amounts due government agencies, categorized by program:


	March 31, 2022		December 31, 2021

	(In millions)
Medicaid program:
Minimum MLR and profit sharing	$	1,033	$	1,016
Other	270		263
Medicare program:
Risk adjustment and Part D risk sharing	105		89
Minimum MLR and profit sharing	103		101
Other	31		35
Marketplace program:
Risk adjustment	949		902
Minimum MLR	20		18
Other	102		48

Total amounts due government agencies	$	2,613	$	2,472

Net Income Per Share (Tables)

3 Months Ended

Mar. 31, 2022

Earnings Per Share [Abstract]

Summary of Denominators for The Computation of Basic and Diluted Earnings Per Share

The following table sets forth the calculation of basic and diluted net income per share:


	Three Months Ended March 31,
	2022		2021

	(In millions, except net income per share)
Numerator:
Net income	$	258	$	228
Denominator:
Shares outstanding at the beginning of the period	57.9		58.0
Weighted-average number of shares issued:
Stock-based compensation	0.1		0.1
Stock purchases	—		(0.4)
Denominator for basic net income per share	58.0		57.7
Effect of dilutive securities: (1)
Stock-based compensation	0.7		0.9

Denominator for diluted net income per share	58.7		58.6

Net income per share - Basic (2)	$	4.45	$	3.95
Net income per share - Diluted (2)	$	4.39	$	3.89

______________________________

(1) The dilutive effect of all potentially dilutive common shares is calculated using the treasury stock method.

(2) Source data for calculations in thousands.

Fair Value Measurements (Tables)

3 Months Ended

Mar. 31, 2022

Fair Value Disclosures [Abstract]

Schedule of Fair Value of Assets Measured on Recurring Basis

Our financial instruments measured at fair value on a recurring basis at March 31, 2022, were as follows:


			Observable Inputs		Directly or Indirectly Observable Inputs		Unobservable Inputs
	Total		(Level 1)		(Level 2)		(Level 3)

	(In millions)
Corporate debt securities	$	1,808	$	—	$	1,808	$	—
Mortgage-backed securities	598		—		598		—
Asset-backed securities	252		—		252		—
U.S. Treasury notes	174		—		174		—
Municipal securities	117		—		117		—



Other	39		—		39		—
Total assets	$	2,988	$	—	$	2,988	$	—

Contingent consideration liabilities	$	8	$	—	$	—	$	8
Total liabilities	$	8	$	—	$	—	$	8

Our financial instruments measured at fair value on a recurring basis at December 31, 2021, were as follows:


			Observable Inputs		Directly or Indirectly Observable Inputs		Unobservable Inputs
	Total		(Level 1)		(Level 2)		(Level 3)

	(In millions)
Corporate debt securities	$	1,833	$	—	$	1,833	$	—
Mortgage-backed securities	614		—		614		—
Asset-backed securities	247		—		247		—
U.S. Treasury notes	353		—		353		—
Municipal securities	123		—		123		—


Other	32		—		32		—
Total assets	$	3,202	$	—	$	3,202	$	—

Contingent consideration liabilities	$	47	$	—	$	—	$	47
Total liabilities	$	47	$	—	$	—	$	47

Schedule of Fair Value Measurements of Senior Notes


	March 31, 2022				December 31, 2021
	Carrying Amount		Fair Value		Carrying Amount		Fair Value

	(In millions)
4.375% Notes due 2028	$	791	$	789	$	791	$	829
3.875% Notes due 2030	642		624		642		675
3.875% Notes due 2032	741		713		740		760
Total	$	2,174	$	2,126	$	2,173	$	2,264

Investments (Tables)

3 Months Ended

Mar. 31, 2022

Investments, Debt and Equity Securities [Abstract]

Schedule of Investments

The following tables summarize our current investments as of the dates indicated:


	March 31, 2022
	Amortized Cost		Gross Unrealized				Estimated Fair Value
			Gains		Losses

	(In millions)
Corporate debt securities	$	1,874	$	1	$	67	$	1,808
Mortgage-backed securities	622		—		24		598
Asset-backed securities	261		—		9		252
U.S. Treasury notes	174		—		—		174
Municipal securities	123		—		6		117



Other	40		—		1		39
Total	$	3,094	$	1	$	107	$	2,988


	December 31, 2021
	Amortized Cost		Gross Unrealized				Estimated Fair Value
			Gains		Losses

	(In millions)
Corporate debt securities	$	1,836	$	9	$	12	$	1,833
Mortgage-backed securities	616		2		4		614
Asset-backed securities	248		—		1		247
U.S. Treasury notes	353		—		—		353
Municipal securities	123		1		1		123


Other	32		—		—		32
Total	$	3,208	$	12	$	18	$	3,202

Schedule of Contractual Maturities of Investments

The contractual maturities of our current investments as of March 31, 2022 are summarized below:


	Amortized Cost		Estimated Fair Value

	(In millions)
Due in one year or less	$	466	$	466
Due after one year through five years	1,733		1,668
Due after five years through ten years	318		306
Due after ten years	577		548
Total	$	3,094	$	2,988

Schedule of Available-for-Sale Investments


	March 31, 2022					December 31, 2021
	Estimated Fair Value		Unrealized Losses		Total Number of Positions	Estimated Fair Value		Unrealized Losses		Total Number of Positions

	(Dollars in millions)
Corporate debt securities	$	1,516	$	67	624	$	1,063	$	12	395
Mortgage-backed securities	582		24		238	408		4		146
Asset-backed securities	208		9		99	166		1		75

Municipal securities	97		6		120	69		1		61
Other	25		1		10	—		—		—



Total	$	2,428	$	107	1,091	$	1,706	$	18	677

Medical Claims and Benefits Payable (Tables)

3 Months Ended

Mar. 31, 2022

Other Liabilities Disclosure [Abstract]

Schedule of Liability for Unpaid Claims and Claims Adjustment Expense

The following table provides the details of our medical claims and benefits payable as of the dates indicated:


	March 31, 2022		December 31, 2021

	(In millions)
Claims incurred but not paid (“IBNP”)	$	2,521	$	2,486
Pharmacy payable	240		219
Capitation payable	95		82
Other	745		576
Total	$	3,601	$	3,363

Schedule of Components of The Change in Medical Claims and Benefits Payable


	Three Months Ended March 31, 2022
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,580	$	404	$	379	$	3,363
Components of medical care costs related to:
Current year	5,424		840		505		6,769
Prior years	(154)		(25)		(27)		(206)
Total medical care costs	5,270		815		478		6,563
Payments for medical care costs related to:
Current year	3,402		465		330		4,197
Prior years	1,633		306		260		2,199
Total paid	5,035		771		590		6,396
Acquired balances, net of post-acquisition adjustments	(25)		—		—		(25)
Change in non-risk and other provider payables	93		3		—		96
Medical claims and benefits payable, ending balance	$	2,883	$	451	$	267	$	3,601


	Three Months Ended March 31, 2021
	Medicaid		Medicare		Marketplace		Consolidated

	(In millions)
Medical claims and benefits payable, beginning balance	$	2,129	$	392	$	175	$	2,696
Components of medical care costs related to:
Current year	4,394		738		536		5,668
Prior years	(158)		(16)		(20)		(194)
Total medical care costs	4,236		722		516		5,474
Payments for medical care costs related to:
Current year	2,790		410		313		3,513
Prior years	1,364		304		113		1,781
Total paid	4,154		714		426		5,294
Acquired balances, net of post-acquisition adjustments	8		(33)		—		(25)
Change in non-risk and other provider payables	(11)		(1)		—		(12)
Medical claims and benefits payable, ending balance	$	2,208	$	366	$	265	$	2,839

Debt (Tables)

3 Months Ended

Mar. 31, 2022

Debt Disclosure [Abstract]

Schedule of Long Term Debt

The following table summarizes our outstanding debt obligations, all of which are non-current as of the dates reported below:


	March 31, 2022		December 31, 2021

	(In millions)




Non-current long-term debt:
4.375% Notes due 2028	$	800	$	800
3.875% Notes due 2030	650		650
3.875% Notes due 2032	750		750
Deferred debt issuance costs	(26)		(27)
Total	$	2,174	$	2,173

- Definition

Tabular disclosure of long-debt instruments or arrangements, including identification, terms, features, collateral requirements and other information necessary to a fair presentation. These are debt arrangements that originally required repayment more than twelve months after issuance or greater than the normal operating cycle of the entity, if longer.

+ References

Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 210
-SubTopic 10
-Section S99
-Paragraph 1
-Subparagraph (SX 210.5-02.22)
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Reference 2: http://www.xbrl.org/2009/role/commonPracticeRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 235
-SubTopic 10
-Section S99
-Paragraph 3
-Subparagraph (SX 210.12-04(a))
-URI http://asc.fasb.org/extlink&oid=120395691&loc=d3e24072-122690

Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
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-Section 45
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Reference 4: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
-Section 50
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-URI http://asc.fasb.org/extlink&oid=123467817&loc=d3e21506-112644

Reference 5: http://www.xbrl.org/2003/role/exampleRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
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-Section 55
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-URI http://asc.fasb.org/extlink&oid=123466577&loc=SL123495735-112612

Reference 6: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
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-Section 45
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Reference 7: http://www.xbrl.org/2003/role/exampleRef
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-Name Accounting Standards Codification
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-URI http://asc.fasb.org/extlink&oid=123466577&loc=SL123495743-112612

Reference 8: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
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Reference 9: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 505
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-Section 50
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-URI http://asc.fasb.org/extlink&oid=123467817&loc=d3e21538-112644

Reference 10: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 942
-SubTopic 470
-Section 50
-Paragraph 3
-URI http://asc.fasb.org/extlink&oid=123599511&loc=d3e64711-112823

Reference 11: http://fasb.org/us-gaap/role/ref/legacyRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 835
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-Section 55
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-URI http://asc.fasb.org/extlink&oid=114775985&loc=d3e28878-108400

Reference 12: http://fasb.org/us-gaap/role/ref/legacyRef
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-Name Accounting Standards Codification
-Topic 505
-SubTopic 10
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-URI http://asc.fasb.org/extlink&oid=123467817&loc=d3e21475-112644

+ Details

Segments (Tables)

3 Months Ended

Mar. 31, 2022

Segment Reporting [Abstract]

Schedule of Operating Segment Information

The following table presents total revenue by segment. Inter-segment revenue was insignificant for all periods presented.


	Three Months Ended March 31,
	2022		2021

	(In millions)
Total revenue:
Medicaid	$	6,187	$	5,020
Medicare	949		805
Marketplace	616		680
Other	18		17
Total	$	7,770	$	6,522

The following table reconciles margin by segment to consolidated income before income taxes.


	Three Months Ended March 31,
	2022		2021

	(In millions)
Margin:
Medicaid	$	710	$	604
Medicare	128		77
Marketplace	130		151
Other	3		4
Total margin	971		836
Add: other operating revenues (1)	221		199
Less: other operating expenses (2)	(820)		(700)
Operating income	372		335
Other expenses, net	28		30
Income before income tax expense	$	344	$	305

______________________

(1)Other operating revenues include premium tax revenue, investment income, and other revenue.

(2)Other operating expenses include general and administrative expenses, premium tax expenses, depreciation and amortization, and other operating expenses.

Organization and Basis of Presentation (Details) member in Millions	1 Months Ended	3 Months Ended
	Sep. 30, 2021	Mar. 31, 2022 segment member position
Segment Reporting Information [Line Items]
Reportable segment \| segment		4
Contract term	4 years
Extension option	2 years
Health Plans
Segment Reporting Information [Line Items]
Number of members eligible for the health care programs, approximately \| member		5.1
Number of states with programs \| position		19
Health Plans \| Minimum
Segment Reporting Information [Line Items]
Contract term		3 years
Health Plans \| Maximum
Segment Reporting Information [Line Items]
Contract term		5 years

Significant Accounting Policies - Cash, Cash Equivalents, and Restricted Cash (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021	Mar. 31, 2021	Dec. 31, 2020
Accounting Policies [Abstract]
Cash and cash equivalents	$ 4,804	$ 4,438	$ 4,431
Restricted cash and cash equivalents	62		66
Total cash, cash equivalents, and restricted cash and cash equivalents presented in the consolidated statements of cash flows	$ 4,866	$ 4,506	$ 4,497	$ 4,223

Significant Accounting Policies - Receivables (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	$ 2,156	$ 2,177
Government receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	1,589	1,566
Pharmacy rebate receivables
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	306	276
Other
Accounts, Notes, Loans and Financing Receivable [Line Items]
Total receivables	$ 261	$ 335

Significant Accounting Policies - Amounts Due To Government Agencies (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Medicaid program:
Minimum MLR and profit sharing	$ 1,033	$ 1,016
Other	270	263
Medicare program:
Risk adjustment and Part D risk sharing	105	89
Minimum MLR and profit sharing	103	101
Other	31	35
Marketplace program:
Risk adjustment	949	902
Minimum MLR	20	18
Other	102	48
Total amounts due government agencies	$ 2,613	$ 2,472

Significant Accounting Policies - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Schedule of Premium Revenue by Health Plan Type [Line Items]
Risk adjustment payable	$ (949)		$ 902
Risk adjustment receivable	33		7
Risk adjustment, net payable	$ 916		$ 895
Maturity period (less than)	15 years
Structured Securities
Schedule of Premium Revenue by Health Plan Type [Line Items]
Average maturity period (less than)	15 years
COVID-19
Schedule of Premium Revenue by Health Plan Type [Line Items]
Reduction in premiums	$ 28	$ 110

Net Income Per Share (Details) - USD ($) $ / shares in Units, shares in Millions, $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021	Dec. 31, 2020
Numerator:
Net income	$ 258	$ 228
Denominator:
Shares outstanding at the beginning of the period ( in shares)			57.9	58.0
Weighted-average number of shares issued:
Stock-based compensation (in shares)	0.1	0.1
Stock purchases (in shares)	0.0	(0.4)
Denominator for basic net income per share (in shares)	58.0	57.7
Effect of dilutive securities:
Stock-based compensation (in shares)	0.7	0.9
Denominator for diluted net income per share (in shares)	58.7	58.6
Net income per share:
Net income per share - Basic (in dollars per share)	$ 4.45	$ 3.95
Net income per share - Diluted (in dollars per share)	$ 4.39	$ 3.89

Business Combinations (Details) - USD ($) $ in Millions			3 Months Ended
Business Combinations (Details) - USD ($) $ in Millions	Jan. 01, 2022	Oct. 25, 2021	Mar. 31, 2022
Magellan Complete Care
Business Acquisition, Contingent Consideration [Line Items]
Total purchase price	$ 60
Goodwill	24
Magellan Complete Care \| Member list
Business Acquisition, Contingent Consideration [Line Items]
Acquired membership with a preliminary fair value	$ 36,000
Affinity Health Plan, Inc
Business Acquisition, Contingent Consideration [Line Items]
Total purchase price		$ 176
Goodwill			$ 11
Medical claims and benefits payable			25
Amounts due government agencies			$ 4

Fair Value Measurements - Financial Instruments on a Recurring Basis (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	$ 2,988	$ 3,202
Total assets	2,988	3,202
Contingent consideration liabilities	8	47
Total liabilities	8	47
Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	1,808	1,833
Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	598	614
Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	252	247
U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	174	353
Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	117	123
Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	39	32
(Level 1)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities	0	0
Total liabilities	0	0
(Level 1) \| Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) \| Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) \| Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) \| U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) \| Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 1) \| Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 2)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	2,988	3,202
Contingent consideration liabilities	0	0
Total liabilities	0	0
(Level 2) \| Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	1,808	1,833
(Level 2) \| Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	598	614
(Level 2) \| Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	252	247
(Level 2) \| U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	174	353
(Level 2) \| Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	117	123
(Level 2) \| Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	39	32
(Level 3)
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Total assets	0	0
Contingent consideration liabilities		47
Total liabilities	8	47
(Level 3) \| Corporate debt securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) \| Mortgage-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) \| Asset-backed securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) \| U.S. Treasury notes
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) \| Municipal securities
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	0	0
(Level 3) \| Other
Fair Value, Assets and Liabilities Measured on Recurring and Nonrecurring Basis [Line Items]
Debt securities, available-for-sale	$ 0	$ 0

Fair Value Measurements - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Recognized gain (loss)	$ 4	$ 8
Contingent consideration liabilities	8		$ 47
Contingent consideration liabilities settled	20	$ 20
(Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration liabilities			$ 47
Passport Health Plan, Inc.
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration liabilities	43
Paid to seller	23
Consideration due for minimum member	20
Passport Health Plan, Inc. \| (Level 3)
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Contingent consideration liabilities	$ 8

Fair Value Measurements - Long-Term Debt (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 2,174	$ 2,173
Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 2,126	2,264
Senior Notes \| 4.375% Notes due 2028
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	4.375%
Senior Notes \| 4.375% Notes due 2028 \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 791	791
Senior Notes \| 4.375% Notes due 2028 \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 789	829
Senior Notes \| 3.875% Notes due 2030
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	3.875%
Senior Notes \| 3.875% Notes due 2030 \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 642	642
Senior Notes \| 3.875% Notes due 2030 \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 624	675
Senior Notes \| 3.875% Notes due 2032
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Debt instrument, interest rate, stated percentage	3.875%
Senior Notes \| 3.875% Notes due 2032 \| Carrying Amount
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 741	740
Senior Notes \| 3.875% Notes due 2032 \| Fair Value
Fair Value, Balance Sheet Grouping, Financial Statement Captions [Line Items]
Fair value of debt	$ 713	$ 760

Investments - Summary of Investments (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	$ 3,094	$ 3,208
Gross unrealized gains	1	12
Gross unrealized losses	107	18
Estimated Fair Value	2,988	3,202
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	1,874	1,836
Gross unrealized gains	1	9
Gross unrealized losses	67	12
Estimated Fair Value	1,808	1,833
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	622	616
Gross unrealized gains	0	2
Gross unrealized losses	24	4
Estimated Fair Value	598	614
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	261	248
Gross unrealized gains	0	0
Gross unrealized losses	9	1
Estimated Fair Value	252	247
U.S. Treasury notes
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	174	353
Gross unrealized gains	0	0
Gross unrealized losses	0	0
Estimated Fair Value	174	353
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	123	123
Gross unrealized gains	0	1
Gross unrealized losses	6	1
Estimated Fair Value	117	123
Other
Debt Securities, Available-for-sale [Line Items]
Amortized Cost	40	32
Gross unrealized gains	0	0
Gross unrealized losses	1	0
Estimated Fair Value	$ 39	$ 32

Investments - Contractual Maturities of Available-for-Sale Investments (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Amortized Cost
Due in one year or less	$ 466
Due after one year through five years	1,733
Due after five years through ten years	318
Due after ten years	577
Amortized Cost	3,094	$ 3,208
Estimated Fair Value
Due in one year or less	466
Due after one year through five years	1,668
Due after five years through ten years	306
Due after ten years	548
Total	$ 2,988

Investments - Narrative (Details) $ in Millions	Mar. 31, 2022 USD ($)
Investments, Debt and Equity Securities [Abstract]
Debt securities held to maturity	$ 221
Amortized cost, due in one year or less	190
Amortized cost, due one year through five years	$ 31

Investments - Available-for-Sale Investments (Details) $ in Millions	Mar. 31, 2022 USD ($) position security	Dec. 31, 2021 USD ($) position security
Debt Securities, Available-for-sale [Line Items]
Estimated Fair Value	$ 2,428	$ 1,706
Unrealized Losses	$ 107	$ 18
Total Number of Positions \| position	1,091	677
Corporate debt securities
Debt Securities, Available-for-sale [Line Items]
Estimated Fair Value	$ 1,516	$ 1,063
Unrealized Losses	$ 67	$ 12
Total Number of Positions \| position	624	395
Mortgage-backed securities
Debt Securities, Available-for-sale [Line Items]
Estimated Fair Value	$ 582	$ 408
Unrealized Losses	$ 24	$ 4
Total Number of Positions \| position	238	146
Asset-backed securities
Debt Securities, Available-for-sale [Line Items]
Estimated Fair Value	$ 208	$ 166
Unrealized Losses	$ 9	$ 1
Total Number of Positions \| security	99	75
Municipal securities
Debt Securities, Available-for-sale [Line Items]
Estimated Fair Value	$ 97	$ 69
Unrealized Losses	$ 6	$ 1
Total Number of Positions \| security	120	61
Other
Debt Securities, Available-for-sale [Line Items]
Estimated Fair Value	$ 25	$ 0
Unrealized Losses	$ 1	$ 0
Total Number of Positions \| security	10	0

Medical Claims and Benefits Payable - Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021	Mar. 31, 2021	Dec. 31, 2020
Other Liabilities Disclosure [Abstract]
Claims incurred but not paid (“IBNP”)	$ 2,521	$ 2,486
Pharmacy payable	240	219
Capitation payable	95	82
Other	745	576
Total	$ 3,601	$ 3,363	$ 2,839	$ 2,696

Medical Claims and Benefits Payable - Narrative (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021	Dec. 31, 2021
Other Liabilities Disclosure [Abstract]
Non-risk provider payables	$ 322		$ 226
Prior period claims, favorable development	$ (206)	$ (194)

Medical Claims and Benefits Payable - Components of Change in Medical Claims and Benefits Payable (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Insurance Claims
Medical claims and benefits payable, beginning balance	$ 3,363	$ 2,696
Components of medical care costs related to:
Current year	6,769	5,668
Prior years	(206)	(194)
Total medical care costs	6,563	5,474
Payments for medical care costs related to:
Current year	4,197	3,513
Prior years	2,199	1,781
Total paid	6,396	5,294
Acquired balances, net of post-acquisition adjustments	(25)	(25)
Change in non-risk and other provider payables	96	(12)
Medical claims and benefits payable, ending balance	3,601	2,839
Medicaid
Insurance Claims
Medical claims and benefits payable, beginning balance	2,580	2,129
Components of medical care costs related to:
Current year	5,424	4,394
Prior years	(154)	(158)
Total medical care costs	5,270	4,236
Payments for medical care costs related to:
Current year	3,402	2,790
Prior years	1,633	1,364
Total paid	5,035	4,154
Acquired balances, net of post-acquisition adjustments	(25)	8
Change in non-risk and other provider payables	93	(11)
Medical claims and benefits payable, ending balance	2,883	2,208
Medicare
Insurance Claims
Medical claims and benefits payable, beginning balance	404	392
Components of medical care costs related to:
Current year	840	738
Prior years	(25)	(16)
Total medical care costs	815	722
Payments for medical care costs related to:
Current year	465	410
Prior years	306	304
Total paid	771	714
Acquired balances, net of post-acquisition adjustments	0	(33)
Change in non-risk and other provider payables	3	(1)
Medical claims and benefits payable, ending balance	451	366
Marketplace
Insurance Claims
Medical claims and benefits payable, beginning balance	379	175
Components of medical care costs related to:
Current year	505	536
Prior years	(27)	(20)
Total medical care costs	478	516
Payments for medical care costs related to:
Current year	330	313
Prior years	260	113
Total paid	590	426
Acquired balances, net of post-acquisition adjustments	0	0
Change in non-risk and other provider payables	0	0
Medical claims and benefits payable, ending balance	$ 267	$ 265

Debt - Schedule of Long-Term Debt (Details) - USD ($) $ in Millions	Mar. 31, 2022	Dec. 31, 2021
Debt Instrument [Line Items]
Deferred debt issuance costs	$ (26)	$ (27)
Total	$ 2,174	2,173
Senior Notes \| 4.375% Notes due 2028
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.375%
Non-current portion of long-term debt	$ 800	800
Senior Notes \| 3.875% Notes due 2030
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Non-current portion of long-term debt	$ 650	650
Senior Notes \| 3.875% Notes due 2032
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Non-current portion of long-term debt	$ 750	$ 750

Debt - Narrative (Details)	3 Months Ended
Debt - Narrative (Details)	Mar. 31, 2022 USD ($)
Line of Credit
Debt Instrument [Line Items]
Debt term	5 years
Line of Credit \| Credit Facility
Debt Instrument [Line Items]
Maximum borrowing capacity	$ 1,000,000,000
Amount outstanding under letter of credit	$ 0
Senior Notes \| 4.375% Notes due 2028
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	4.375%
Face amount	$ 800,000,000
Senior Notes \| 3.875% Notes due 2030
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Face amount	$ 650,000,000
Senior Notes \| 3.875% Notes due 2032
Debt Instrument [Line Items]
Percentage of contractual interest rate on notes	3.875%
Face amount	$ 750,000,000

Stockholders' Equity (Details) - USD ($)		3 Months Ended
Stockholders' Equity (Details) - USD ($)	Apr. 27, 2022	Mar. 31, 2021	Sep. 30, 2021
Subsequent event
Class of Stock [Line Items]
Repurchased of common stock (in shares)	85,000
Common Stock
Class of Stock [Line Items]
Common stock authorized			$ 500,000,000
Repurchased of common stock (in shares)		1,000,000

Segments - Narrative (Details)	Mar. 31, 2022 segment
Segment Reporting [Abstract]
Reportable segment	4

Segments - Schedule of Operating Segment Information (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Revenues	$ 7,770	$ 6,522
Medicaid
Segment Reporting Information [Line Items]
Revenues	6,187	5,020
Medicare
Segment Reporting Information [Line Items]
Revenues	949	805
Marketplace
Segment Reporting Information [Line Items]
Revenues	616	680
Other
Segment Reporting Information [Line Items]
Revenues	$ 18	$ 17

- Definition

Amount of revenue recognized from goods sold, services rendered, insurance premiums, or other activities that constitute an earning process. Includes, but is not limited to, investment and interest income before deduction of interest expense when recognized as a component of revenue, and sales and trading gain (loss).

+ References

Reference 1: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 22
-Subparagraph (a)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8736-108599

Reference 2: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 323
-SubTopic 10
-Section 50
-Paragraph 3
-Subparagraph (c)
-URI http://asc.fasb.org/extlink&oid=114001798&loc=d3e33918-111571

Reference 3: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 825
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-Section 50
-Paragraph 28
-Subparagraph (f)
-URI http://asc.fasb.org/extlink&oid=123596393&loc=d3e14064-108612

Reference 4: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
-Section 50
-Paragraph 32
-Subparagraph (b)
-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8933-108599

Reference 5: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
-SubTopic 10
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Reference 6: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
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-Section S99
-Paragraph 1B
-Subparagraph (SX 210.13-02(a)(4)(iv))
-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 7: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
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Reference 8: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442526-122756

Reference 9: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 10: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 11: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 12: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 470
-SubTopic 10
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-URI http://asc.fasb.org/extlink&oid=124359900&loc=SL124442552-122756

Reference 13: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 280
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-URI http://asc.fasb.org/extlink&oid=123359005&loc=d3e8906-108599

Reference 14: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 15: http://www.xbrl.org/2003/role/disclosureRef
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Reference 16: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 17: http://www.xbrl.org/2003/role/disclosureRef
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-Name Accounting Standards Codification
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Reference 18: http://www.xbrl.org/2003/role/disclosureRef
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Reference 22: http://www.xbrl.org/2009/role/commonPracticeRef
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-Name Accounting Standards Codification
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Reference 23: http://www.xbrl.org/2003/role/disclosureRef
-Publisher FASB
-Name Accounting Standards Codification
-Topic 220
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-Subparagraph (SX 210.5-03(1))
-URI http://asc.fasb.org/extlink&oid=123367319&loc=SL114868664-224227

+ Details

Segments - Reconciliation of Gross Margin to Consolidated Income (Details) - USD ($) $ in Millions	3 Months Ended
	Mar. 31, 2022	Mar. 31, 2021
Segment Reporting Information [Line Items]
Add: other operating revenues	$ 7,770	$ 6,522
Less: other operating expenses	(7,398)	(6,187)
Operating income	372	335
Other expenses, net	28	30
Income before income tax expense	344	305
Medicaid
Segment Reporting Information [Line Items]
Add: other operating revenues	6,187	5,020
Medicare
Segment Reporting Information [Line Items]
Add: other operating revenues	949	805
Marketplace
Segment Reporting Information [Line Items]
Add: other operating revenues	616	680
Other
Segment Reporting Information [Line Items]
Add: other operating revenues	18	17
Operating segments
Segment Reporting Information [Line Items]
Total margin	971	836
Operating segments \| Medicaid
Segment Reporting Information [Line Items]
Total margin	710	604
Operating segments \| Medicare
Segment Reporting Information [Line Items]
Total margin	128	77
Operating segments \| Marketplace
Segment Reporting Information [Line Items]
Total margin	130	151
Operating segments \| Other
Segment Reporting Information [Line Items]
Total margin	3	4
Other operating
Segment Reporting Information [Line Items]
Add: other operating revenues	221	199
Less: other operating expenses	$ (820)	$ (700)