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CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS (Unaudited) - USD ($)
$ in Millions
6 Months Ended
Jun. 30, 2024
Jun. 30, 2023
Cash flows from operating activities    
Net income $ 1,417 $ 2,194
Adjustments to reconcile net income to net cash provided by operating activities:    
Loss on investment securities, net 0 45
Equity in net losses 41 27
Stock-based compensation 100 89
Depreciation 454 410
Amortization 31 34
Impairment of property and equipment 87 0
Changes in operating assets and liabilities, net of effect of businesses acquired and disposed:    
Receivables (2,055) 269
Other assets 592 (1,141)
Benefits payable 1,205 978
Other liabilities (327) (170)
Unearned revenues 47 7,092
Other 44 36
Net cash provided by operating activities 1,636 9,863 Close
Cash flows from investing activities    
Acquisitions, net of cash and cash equivalents acquired (17) (189)
Purchases of property and equipment, net (291) (487)
Purchases of investment securities (2,962) (2,737)
Proceeds from maturities of investment securities 1,355 577
Proceeds from sales of investment securities 499 811
Net cash used in investing activities (1,416) (2,025) Close
Cash flows from financing activities    
Receipts from contract deposits, net 285 3,510
Proceeds from issuance of senior notes, net 2,232 1,215
Repayments of senior notes (34) (349)
(Repayments) issuance of commercial paper, net (895) 238
Repayment of term loan 0 (500)
Debt issue costs (7) (4)
Change in book overdraft 2 159
Common stock repurchases (766) (623)
Dividends paid (216) (211)
Other (14) (120)
Net cash provided by financing activities 587 3,315 Close
Increase in cash and cash equivalents 807 11,153 Close
Cash and cash equivalents at beginning of period 4,694 5,061
Cash and cash equivalents at end of period 5,501 16,214
Supplemental cash flow disclosures:    
Interest payments 250 175
Income tax payments, net 362 681
Details of businesses acquired in purchase transactions:    
Fair value of assets acquired, net of cash and cash equivalents acquired 26 346
Less: Fair value of liabilities assumed (9) (162)
Less: Noncontrolling interests acquired 0 5
Cash paid for acquired businesses, net of cash and cash equivalents acquired $ 17 $ 189