This report provides an analysis of the recently released 2019 Centers for Medicare and Medicaid Services (CMS) Medicaid and Children’s Health Insurance Program (CHIP) Scorecard. This is the second annual release of the Scorecard. As in our analysis of last year’s Scorecard, we primarily focus on the quality metrics included in the Scorecard, based on the Child and Adult Core Set data. Due to material differences in how states report these measures to CMS, our analysis controls for key differences in state-level reporting methodologies to provide meaningful comparisons. For states with available data, quality metrics have been summarized into a state profile report (provided in a separate document), illustrating how a state’s quality metrics measure relative to other states, controlling for variances in reporting methodologies and underlying populations for each quality measure.