v3.21.2
CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($)
$ in Millions
9 Months Ended
Sep. 30, 2021
Sep. 30, 2020
Cash flows from operating activities:    
Net earnings $ 743 $ 1,813
Adjustments to reconcile net earnings to net cash provided by operating activities    
Depreciation and amortization 1,098 916
Stock compensation expense 127 218
Impairment 229 72
Loss on debt extinguishment 125 44
Gain on acquisition (309) 0
Deferred income taxes (143) (154)
Gain on divestiture 62 (104)
Other adjustments, net (6) 0
Changes in assets and liabilities    
Premium and trade receivables (1,723) (1,640)
Other assets (124) 185
Medical claims liabilities 1,661 1,563
Unearned revenue (169) (212)
Accounts payable and accrued expenses 993 (861)
Other long-term liabilities 964 663
Other operating activities, net 2 19
Net cash provided by operating activities 3,530 2,522
Cash flows from investing activities:    
Capital expenditures (662) (663)
Purchases of investments (5,253) (2,911)
Sales and maturities of investments 4,069 3,408
Acquisitions, net of cash acquired (534) (3,000)
Divestiture proceeds, net of divested cash (62) 466
Net cash used in investing activities (2,442) (2,700)
Cash flows from financing activities:    
Proceeds from long-term debt 9,247 2,687
Payments of long-term debt (7,411) (1,654)
Common stock repurchases (49) (570)
Payments for debt extinguishment (157) (21)
Debt issuance costs (72) (94)
Other financing activities, net 39 35
Net cash provided by financing activities 1,597 383
Effect of exchange rate changes on cash, cash equivalents, and restricted cash (8) 8
Net increase in cash, cash equivalents and restricted cash and cash equivalents 2,677 213
Cash, cash equivalents, and restricted cash and cash equivalents, beginning of period 10,957 12,131
Cash, cash equivalents, and restricted cash and cash equivalents, end of period 13,634 12,344
Supplemental disclosures of cash flow information:    
Interest paid 479 479
Income taxes paid 477 920
Equity issued in connection with acquisitions 0 11,526
The following table provides a reconciliation of cash, cash equivalents, and restricted cash and cash equivalents reported within the Consolidated Balance Sheets to the totals above:    
Cash and cash equivalents 13,423 12,198
Restricted cash and cash equivalents, included in restricted deposits 211 146
Total cash, cash equivalents, and restricted cash and cash equivalents $ 13,634 $ 12,344

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