California has more people enrolled in Medicaid than any other state—almost 15 million of 93 million enrollees nationwide, and the state’s efforts to equitably address the enrollment churn make it worth watching. When the pause on Medicaid redeterminations ended in April, up to 3 million Medi-Cal enrollees, California’s program, were at risk of losing coverage. Most at risk are those often eligible but inconsistently enrolled in Medi-Cal—if at all. Many of these individuals are from poorly served communities who often experience longstanding discrimination in accessing health care. They commonly live in extremely rural areas and lack access to the internet and transportation; have unstable housing; are reluctant to enroll due to their immigration status; and have limited English proficiency, live with a physical disability, or have behavioral health needs. If Medi-Cal is to be a true driver for health equity, we need to close the enrollment gap in these communities.