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Consolidated Statements of Cash Flows - USD ($)
$ in Millions
 3 Months Ended
Mar. 31, 2024
Mar. 31, 2023
Cash Flows from Operating Activities    
Net income $ (212) $ 1,306
Adjustments to reconcile net (loss) income to net cash provided by operating activities:    
Depreciation and amortization 741 749
Realized investment losses, net 1,836 56
Deferred income tax benefit (102) (108)
Loss on sale of businesses 19 0
Net changes in assets and liabilities, net of non-operating effects:    
Accounts receivable, net (2,687) (479)
Inventories 1,015 566
Reinsurance recoverable and Other assets 68 72
Insurance liabilities 532 1,533
Pharmacy and other service costs payable 4,637 539
Accounts payable and Accrued expenses and other liabilities (1,068) 690
Other, net 61 104
NET CASH PROVIDED BY OPERATING ACTIVITIES 4,840 5,028 Close
Proceeds from investments sold:    
Debt securities and equity securities 268 196
Investment maturities and repayments:    
Debt securities and equity securities 179 257
Commercial mortgage loans 4 4
Other sales, maturities and repayments (primarily short-term and other long-term investments) 272 160
Investments purchased or originated:    
Debt securities and equity securities (180) (2,794)
Commercial mortgage loans (32) 0
Other (primarily short-term and other long-term investments) (594) (377)
Property and equipment purchases, net (300) (408)
Divestitures, net of cash sold 0 22
Other, net (112) (43)
NET CASH USED IN INVESTING ACTIVITIES (495) (2,983) Close
Cash Flows from Financing Activities    
Deposits and interest credited to contractholder deposit funds 43 45
Withdrawals and benefit payments from contractholder deposit funds (65) (48)
Net change in short-term debt (364) (9)
Repayment of long-term debt (2,210) (80)
Net proceeds on issuance of long-term debt 4,462 1,491
Repurchase of common stock (4,022) (962)
Issuance of common stock 181 30
Common stock dividend paid (401) (368)
Other, net (153) (136)
NET CASH USED IN FINANCING ACTIVITIES (2,529) (37) Close
Effect of foreign currency rate changes on cash, cash equivalents and restricted cash (9) 5 Close
Net increase in cash, cash equivalents and restricted cash 1,807 2,013 Close
Cash, cash equivalents and restricted cash January 1, including held for sale assets 8,337 5,976
Cash, cash equivalents and restricted cash December 31, including held for sale assets [1] 10,144 7,989
Cash and cash equivalents reclassified to assets of businesses held for sale (1,660) 0
Cash, cash equivalents and restricted cash and cash equivalents December 31, [1] 8,484 7,989
Supplemental Disclosure of Cash Information:    
Income taxes paid, net of refunds 110 77
Interest paid $ 336 $ 322
[1] Restricted cash and cash equivalents were reported in other long-term investments.