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Income Taxes (Tables)
12 Months Ended
Dec. 31, 2018
Income Tax Disclosure [Abstract]  
Schedule of Components of Income Tax Expense (Benefit)

The income tax provision for continuing operations consisted of the following for the years ended December 31:
 
 
 
 
 
 
In millions
2018
    
2017
    
2016
Current:
 
 
 
 
 
Federal
$
1,480

 
$
2,594

 
$
2,803

State
499

 
464

 
511

 
1,979

 
3,058

 
3,314

Deferred:
 
 
 
 
 
Federal
22

 
(1,435
)
 
5

State
1

 
14

 
(2
)
 
23

 
(1,421
)
 
3

Total
$
2,002

 
$
1,637

 
$
3,317

 
 
 
 
 
 

Schedule of Effective Income Tax Rate Reconciliation
The following table is a reconciliation of the statutory income tax rate to the Company’s effective income tax rate for continuing operations for the years ended December 31:
 
 
 
 
 
 
 
2018
    
2017
    
2016
Statutory income tax rate
21.0
 %
 
35.0
 %
 
35.0
 %
State income taxes, net of federal tax benefit
27.7

 
4.1

 
4.1

Effect of the Tax Cuts and Jobs Act
(7.1
)
 
(18.3
)
 

Health insurer fee
2.2

 

 
0.2

Goodwill impairments
89.5

 
0.8

 

Sale of subsidiary
5.0

 

 

Other
4.1

 
(1.8
)
 
(0.9
)
Effective income tax rate
142.4
 %
 
19.8
 %
 
38.4
 %
 
 
 
 
 
 

Schedule of Deferred Tax Assets and Liabilities
The following table is a summary of the components of the Company’s deferred income tax assets and liabilities as of December 31:
 
 
 
 
In millions
2018
    
2017
Deferred income tax assets:
 
 
 
Lease and rents
$
277

 
$
291

Inventory
28

 
31

Employee benefits
243

 
246

Allowance for doubtful accounts
243

 
187

Retirement benefits
130

 
40

Net operating loss and capital loss carryforwards
529

 
101

Deferred income
104

 
93

Insurance reserves
467

 

Investments
11

 

Other
242

 
18

Valuation allowance
(520
)
 
(77
)
Total deferred income tax assets
1,754

 
930

Deferred income tax liabilities:
 
 
 
Depreciation and amortization
(9,431
)
 
(3,926
)
Total deferred income tax liabilities
(9,431
)
 
(3,926
)
Net deferred income tax liabilities
$
(7,677
)
 
$
(2,996
)
 
 
 
 

Schedule of Unrecognized Tax Benefits Roll Forward
A reconciliation of the beginning and ending amount of unrecognized tax benefits is as follows:
 
 
 
 
 
 
In millions
2018
    
2017
    
2016
Beginning balance
$
344

 
$
307

 
$
338

Additions based on tax positions related to the current year
1

 
62

 
68

Additions based on tax positions related to prior years
324

 
32

 
70

Reductions for tax positions of prior years
(5
)
 
(28
)
 
(100
)
Expiration of statutes of limitation
(2
)
 
(10
)
 
(22
)
Settlements
(1
)
 
(19
)
 
(47
)
Ending balance
$
661

 
$
344

 
$
307