Despite the significant gains in terms of health coverage, access, and utilization made since implementation of the Affordable Care Act (ACA), racial health disparity remains omnipresent in California. While a radical force for change in many respects, the ACA’s reforms were largely built atop our pre-existing health care system, inheriting its disparities. As health disparity drivers abound in and outside our health care system – undermining our state’s well-being daily – agents capable of advancing health equity become even more vital.