Although California has a national reputation for advancing progressive health care policies, California’s communities of color, including lesbian, gay, bisexual, transgender and queer (LGBTQ+) individuals and persons with disabilities, continue to experience discrimination and have poorer outcomes on key health indicators including asthma, diabetes and mental health than other Californians. Despite individual actions and intentions, our health care system as designed often makes health outcomes worse, particularly for communities of color, by perpetuating the very inequities it seeks to address. The imperative to address these systemic inequities is urgent, particularly now against the backdrop of COVID-19 disparities and protests against anti-Black racism and continued violence against Black and Brown communities, sparked by the murder of George Floyd.