# States M1 Enrollment tracker: medicaid_mco_state_month_reconciliation_mat_v1

`medicare_silver.medicaid_mco_state_month_reconciliation_mat_v1` · State programs · status partial · 3,738 rows

Medicaid product M1 (Enrollment tracker) of the States lane: the Medicaid MCO enrollment tracker: members by plan and parent by state by month, every cell graded (observed, estimated, untested, not published), with parent rollups and the quarterly tie-out to what public parents report to the SEC. Start from medicaid_mco_enrollment_tracker_v2 (state x plan x parent x month) or its views vw_medicaid_mco_enrollment_tracker_v2_parent_state_month / _parent_national_month. READ basis ON EVERY ROW: observed is the state's printed figure; estimated is ours, and method names how (M-a carry-forward, M-b plan share x state total, M-e the tracker's nowcast model, PUB-PRELIM the publisher's own preliminary estimate; docs/research/states/M1-TRACKER-V2-DESIGN.md section 4), with interval_low / interval_high, inputs_as_of and assumption_ids. modeled is an M-e value where the method missed the accuracy bar: INDICATIVE ONLY, its interval is the measured error, and it is excluded from members_total; never sum it into an observed or estimated total (the views carry members_observed, members_estimated, members_modeled and members_with_modeled apart). not_published and not_applicable rows have members null: they are not zeros. Filter measure_class (members, member_months, weighted_members, average_monthly_members) and never add across it: average_monthly_members (with averaging_window; RI from 2023-12 prints average daily enrollment per month) never adds into members. measure is the publisher's own label. California is observed 2021-01..2026-09; Kaiser's publisher-suppressed county cells carry a labelled lower bound (assumption A-SUPPRESSED-LB). TWO PARENT QUESTIONS, two view pairs: the dated views vw_medicaid_mco_enrollment_tracker_v2_parent_dated_state_month / _parent_dated_national_month answer 'who owned it then' (parent_as_of_month; WellCare is its own parent before 2020, so Centene July 2016 is 5.92M there); the current views _parent_state_month / _parent_national_month answer 'today's companies' history' (Centene July 2016 is 9.93M there), with parent the CURRENT binding today (parent_status, parent_basis); never mix the two in one series. Assumptions: medicaid_mco_enrollment_assumption_v1 is the per-state register (populations counted, count basis, auto-assignment, carve-ins); medicaid_mco_enrollment_assumptions_v1 is the build's. SEC: read capture ratios only from vw_medicaid_mco_enrollment_tracker_v2_sec_tieout (like for like, duals adjusted per docs/research/states/M1-SEC-COUNT-BASIS.csv); comparability_class says when the filed number is broader than the tracker. SHOW THE GRADED adj_* COLUMNS, NEVER ONLY THE RATIO: each adjustment is its own labelled column (e.g. adj_subcontract_molina_la / _out measured from DMHC, adj_risk_share_healthy_blue_nc, adj_subcontract_lacare_anthem ESTIMATED with its low bound in the detail, adj_dsnp_from_ma_gap a JUDGMENT that a dual is counted in both lines, the 'once' alternative in the detail); a capture above 1.00 (UNH Q2 2026 1.007) means a judgment column over-explains. The two NY columns keep their _held names for schema stability but are LIVE: adj_ny_chp_held (NY Child Health Plus members, CNC 188,720, ELV 40,405) and sec_ny_essential_plan_excluded_held (NY Essential Plan is not Medicaid and comes off the SEC side, CNC -388,602), source NY DOH healthweb-back.health.ny.gov, recorded by the States lane as allowed by Ben on 2026-11-01; null where no NY figure exists or it is not measured (UNH), never zero. sec_asc_excluded is per quarter; exits are listed apart. ESTIMATE INTERVALS widen with the TOTAL horizon where the state total is carried past its last published month (months since the last observed plan value + months the total is carried): inputs_as_of is the last published total month and value_status says 'state total carried from <month>'. TEXAS: observed monthly by MCO x program 2007-09..2026-02 from HHSC MCO Financial Statistical Reports (tx_medicaid_mco_fsr_member_months_v1: filter is_latest_filing = true, since restated filings stay as rows, and grain); after 2026-02 plan values scale by HHSC's own monthly total. 234 TX observed members rows are FRACTIONAL by rule (part-month adjustments in the filed member months; HHSC defines the line as members enrolled in the month and it ties to HHSC final SFY averages within 0.04-0.38%, assumption A-TX-FSR-RETRO): they stay measure_class members, never rounded, so a fractional-members check exempts source_family state_fsr. measure_class members_hhsc_prelim_plan_total (HHSC 2026-05 preliminary per-plan totals) never adds to members. tx_medicaid_mco_enrollment_other_sources_v1 holds TDI HMO quarter-ends, 1115 waiver tables, CHIP 2003-13 and HHSC preliminary months, one series per row (filter series and period_kind), never mixed with the FSR months. INPUTS behind the tracker, read only with their labels: medicaid_m1_program_observation_v1 is the programs the spine lacked (MN, PA CHC, NY MLTC/MAP/FIDA-IDD, IN PathWays, CO Denver Health, OH MyCare, WI Family Care, WV MHP, CA SCAN, DC Dual Choice), one row per published cell (read value_unit and source_time_basis: some are member months). medicaid_mco_plan_enrollment_hunt_v1 and _hunt_cogank_v1 are hunted series (ND VT CO GA monthly, MA AR quarterly, NE EQR points, KS year-to-date averages): filter tracker_use, because only observed_monthly and observed_point rows are observations; quarterly_anchor and average_anchor are anchors, check_only and not_read are never a figure, and grain says month, quarter, rolling_quarter, calendar_ytd or point_in_time. medicaid_mcpar_plan_avg_enrollment_v1 is MCPAR annual average monthly members by plan (PY2023-25, 48 states), an anchor only, never a monthly count; suspect = true rows (77) are flagged. medicaid_mco_state_month_reconciliation_mat_v1 is the earlier plan-sum vs state and CMS totals reconciliation (cms_monthly_denominator_available = false is a missing denominator, never zero). 31 state(s): AZ CA DC FL GA HI IA IL IN KY LA MI MN MO MS NJ NM NV NY OK OR PA RI SC TN TX UT VA WA WI WV.

**Grain.** The Medicaid MCO enrollment tracker: members by plan and parent by state by month, every cell graded (observed, estimated, untested, not published), with parent rollups and the quarterly tie-out to what public parents report to the SEC. 3,738 rows (Athena, 2026-10-29). Period 2000-01-01 to 2026-10-01 (observation_month).

| column | type | meaning |
|---|---|---|
| state_code | varchar(2) |  |
| observation_month | date |  |
| reported_managed_medicaid_plan_membership_exposure | double |  |
| plan_observation_rows | bigint |  |
| plan_identities | bigint |  |
| included_program_classes | string |  |
| plan_source_tables | string |  |
| unresolved_or_ambiguous_identity_rows | bigint |  |
| total_medicaid_enrollment | bigint |  |
| total_chip_enrollment | bigint |  |
| total_medicaid_and_chip_enrollment | bigint |  |
| contextual_medicaid_minus_plan_exposure | double |  |
| plan_exposure_to_medicaid_ratio | double |  |
| report_revision | string |  |
| final_report | string |  |
| is_final_report | boolean |  |
| cms_source_url | string |  |
| cms_source_hash | string |  |
| cms_semantic_row_sha256 | string |  |
| cms_monthly_denominator_available | boolean |  |
| reported_plan_membership_exposure | boolean |  |
| contextual_residual_promoted_as_ffs | boolean |  |
| component_waterfall_complete | boolean |  |
| unduplicated_beneficiary_total_authorized | boolean |  |
| national_aggregation_authorized | boolean |  |
| waterfall_component_basis | varchar(65) |  |
| waterfall_comprehensive_capitated_total | double |  |
| waterfall_comprehensive_capitated_not_in_plan_rows | double |  |
| waterfall_mma_specialty | bigint |  |
| waterfall_mma_child_welfare | bigint |  |
| waterfall_childrens_medical_services | bigint |  |
| waterfall_pace | bigint |  |
| waterfall_ffs_mma_eligible | bigint |  |
| waterfall_ffs_tpl | bigint |  |
| waterfall_ffs_excluded_from_mma | bigint |  |
| waterfall_publisher_total | bigint |  |
| waterfall_chip_inside_publisher_total | double |  |
| waterfall_explained_non_plan_medicaid | double |  |
| waterfall_unexplained_residual | bigint |  |
| waterfall_residual_label | varchar(475) |  |
| waterfall_source_file | string |  |
| waterfall_source_document_sha256 | string |  |
| waterfall_residual_before_definitional_exclusions | bigint |  |
| definitional_partial_dual_excluded_by_cms | bigint |  |
| definitional_qmb_only | bigint |  |
| definitional_slmb_only | bigint |  |
| definitional_qi_qdwi | bigint |  |
| definitional_exclusion_label | varchar(316) |  |
| definitional_source_url | string |  |
| definitional_source_hash | string |  |
| waterfall_chc_capitated | bigint |  |
| waterfall_ffs_and_other_derived | double |  |
| waterfall_chip_separate_outside_total | bigint |  |
| waterfall_chip_inside_basis | varchar(232) |  |
| waterfall_ffs_and_other_label | varchar(271) |  |
| waterfall_nj_familycare_mco_total | bigint |  |
| waterfall_nj_ffs_or_pace | bigint |  |
| waterfall_nj_mchip | bigint |  |
| waterfall_nj_schip | bigint |  |
| waterfall_nj_hmo_source_hashes | string |  |
| waterfall_ny_mmc_publisher_total | bigint |  |
| waterfall_ny_harp | bigint |  |
| waterfall_ny_mltc | bigint |  |
| waterfall_ny_map | bigint |  |
| waterfall_ny_fida_idd | bigint |  |
| waterfall_tx_medicaid_managed_care_total | bigint |  |
| waterfall_tx_star_plus | bigint |  |
| waterfall_tx_star_health | bigint |  |
| waterfall_tx_dual_demo | bigint |  |
| waterfall_il_mc_publisher_total | bigint |  |
| waterfall_il_partial_benefits | bigint |  |
| waterfall_il_state_only_hbia | bigint |  |
| waterfall_il_state_only_hbis | bigint |  |
| waterfall_mi_medicaid_eligible | bigint |  |
| waterfall_mi_healthy_michigan_plan | bigint |  |
| waterfall_az_acute_plans_subtotal | bigint |  |
| waterfall_az_altcs_pc_subtotal | bigint |  |
| waterfall_az_ffs_subtotal | bigint |  |
| waterfall_az_msp_subtotal | bigint |  |
| waterfall_az_emergency_services | bigint |  |
| waterfall_az_qmb_only | bigint |  |
| waterfall_az_slmb | bigint |  |
| waterfall_az_qi1 | bigint |  |
| waterfall_az_transplant_option | bigint |  |
| waterfall_az_kidscare | bigint |  |
| waterfall_az_printed_exclusions | bigint |  |
| waterfall_ia_mco_medicaid | int |  |
| waterfall_ia_ffs_medicaid | int |  |
| waterfall_ia_hawki_medical | int |  |
| waterfall_ia_hawki_dental_only | int |  |
| waterfall_ia_medicaid_dental_only | int |  |
| waterfall_ia_medicaid_expansion_chip_proxy | bigint |  |
| waterfall_ia_dental_source_hash | varchar(64) |  |
| waterfall_ia_medical_source_locator | string |  |
| waterfall_ia_dental_source_locator | string |  |
| waterfall_nm_ffs | bigint |  |
| waterfall_nm_unassigned | bigint |  |
| waterfall_nm_family_planning | bigint |  |
| waterfall_nm_emergency_only | bigint |  |
| waterfall_nm_coe_vs_total_delta | bigint |  |
| waterfall_nm_source_locators | string |  |
| waterfall_nv_chip_caseload | bigint |  |
| waterfall_nv_chip_mco | bigint |  |
| waterfall_nv_dashboard_slmb | bigint |  |
| waterfall_nv_dashboard_mco_delta | bigint |  |
| waterfall_nv_chip_mco_vs_caseload_delta | bigint |  |
| waterfall_nv_source_locators | string |  |
| materialized_at | timestamp |  |
| waterfall_va_title_xix_total | bigint |  |
| waterfall_va_title_xxi_total | bigint |  |
| waterfall_va_mco_total | bigint |  |
| waterfall_va_mco_title_xix_total | bigint |  |
| waterfall_va_pace | bigint |  |
| waterfall_va_qmb_qi_limited | bigint |  |
| waterfall_va_doc_emergency_limited | bigint |  |
| waterfall_va_family_planning_limited | bigint |  |
| waterfall_va_aca_doc_emergency_limited | bigint |  |
| waterfall_va_printed_exclusions | bigint |  |
| waterfall_va_plan_rows_minus_mco_total | double |  |
| waterfall_va_source_locators | string |  |
| waterfall_tn_select | bigint |  |
| waterfall_tn_kbb_didd | bigint |  |
| waterfall_tn_awaiting | bigint |  |
| waterfall_tn_source_locators | string |  |
| waterfall_wa_chp | bigint |  |
| waterfall_wa_mcs | bigint |  |
| waterfall_wa_aem | bigint |  |
| waterfall_wa_pccm | bigint |  |
| waterfall_wa_source_locators | string |  |
| waterfall_wa_fimc_minus_plan_rows | double |  |

Query it: `query_substrate` with `SELECT ... FROM medicare_silver.medicaid_mco_state_month_reconciliation_mat_v1 WHERE ... LIMIT 100`; read `describe_data_source("medicare_silver.medicaid_mco_state_month_reconciliation_mat_v1")` first.