Income Taxes (Tables)

12 Months Ended

Dec. 31, 2020

Income Tax Disclosure [Abstract]

Schedule of Provision for Income Taxes

The provision for income taxes consists of the following (dollars in millions):

	2020			2019			2018
Current:
Federal	$	1,021		$	670		$	759
State		126			134			149
Foreign		5			17			23
Deferred:
Federal		(73	)		254			9
State		(39	)		29			13
Foreign		3			(5	)		(7	)
	$	1,043		$	1,099		$	946

Schedule of Reconciliation of Federal Statutory Rate to Effective Income Tax Rate

A reconciliation of the federal statutory rate to the effective income tax rate follows:

	2020			2019			2018
Federal statutory rate		21.0	%		21.0	%		21.0	%
State income taxes, net of federal tax benefit		1.9			2.7			2.9
Change in liability for uncertain tax positions		(0.2	)		0.4			(0.1	)
Tax benefit from settlements of employee equity awards		(1.8	)		(1.3	)		(2.4	)
Impact of Tax Act on deferred tax balances		—			—			(1.6	)
Other items, net		0.8			1.1			0.2
Effective income tax rate on income attributable to HCA Healthcare, Inc.		21.7			23.9			20.0
Income attributable to noncontrolling interests from consolidated partnerships		(2.5	)		(2.9	)		(2.3	)
Effective income tax rate on income before income taxes		19.2	%		21.0	%		17.7	%

Schedule of Deferred Tax Assets and Liabilities

A summary of the items comprising the deferred tax assets and liabilities at December 31 follows (dollars in millions):

	2020				2019
	Assets		Liabilities		Assets		Liabilities
Depreciation and fixed asset basis differences	$	—	$	678	$	—	$	601
Allowances for professional liability and other risks		407		—		376		—
Accounts receivable		283		—		307		—
Compensation		487		—		292		—
Right-of-use lease assets and obligations		416		409		369		366
Other		485		606		461		538
	$	2,078	$	1,693	$	1,805	$	1,505

Schedule of Activity Related to Unrecognized Tax Benefits

The following table summarizes the activity related to our unrecognized tax benefits (dollars in millions):

	2020			2019
Balance at January 1	$	522		$	390
Additions (reductions) based on tax positions related to the current year		(3	)		29
Additions for tax positions of prior years		13			119
Reductions for tax positions of prior years		(30	)		(3	)
Settlements		(22	)		—
Lapse of applicable statutes of limitations		(11	)		(13	)
Balance at December 31	$	469		$	522