Income Taxes (Tables)

12 Months Ended

Dec. 31, 2021

Income Tax Disclosure [Abstract]

Schedule of Provision for Income Taxes

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

	2021			2020			2019
Current:
Federal	$	1,769		$	1,021		$	670
State		311			126			134
Foreign		15			5			17
Deferred:
Federal		24			(73	)		254
State		(18	)		(39	)		29
Foreign		11			3			(5	)
	$	2,112		$	1,043		$	1,099

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:

	2021			2020			2019
Federal statutory rate		21.0	%		21.0	%		21.0	%
State income taxes, net of federal tax benefit		2.0			1.9			2.7
Change in liability for uncertain tax positions		0.7			(0.2	)		0.4
Tax benefit from settlements of employee equity awards		(1.2	)		(1.8	)		(1.3	)
Other items, net		0.8			0.8			1.1
Effective income tax rate on income attributable to HCA Healthcare, Inc.		23.3			21.7			23.9
Income attributable to noncontrolling interests from consolidated partnerships		(1.8	)		(2.5	)		(2.9	)
Effective income tax rate on income before income taxes		21.5	%		19.2	%		21.0	%

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):

	2021				2020
	Assets		Liabilities		Assets		Liabilities
Depreciation and fixed asset basis differences	$	—	$	737	$	—	$	678
Allowances for professional liability and other risks		426		—		407		—
Accounts receivable		348		—		283		—
Compensation		502		—		487		—
Right-of-use lease assets and obligations		428		419		416		409
Other		499		652		485		606
	$	2,203	$	1,808	$	2,078	$	1,693

Schedule of Activity Related to Unrecognized Tax Benefits

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

	2021			2020
Balance at January 1	$	469		$	522
Additions based on tax positions related to the current year		57			(3	)
Additions for tax positions of prior years		66			13
Reductions for tax positions of prior years		(6	)		(30	)
Settlements		(3	)		(22	)
Lapse of applicable statutes of limitations		(7	)		(11	)
Balance at December 31	$	576		$	469