One-third of eligible residents in California remained uninsured in the beginning of 2016. The California Endowment not only supported outreach and enrollment campaigns to help the eligible residents get health coverage, it also funded efforts to address the lack of health care coverage for undocumented residents. Community Science evaluated the systems impact of The Endowment’s efforts and in particular, investigated the alignment of its local and statewide investments in the provisions set forth by the Affordable Care Act, and in the development of community capacity to increase health care access.