Health disparities in the state are stark.
"Diabetes affects 13 percent of Native Americans in the state, 11 percent of Latinos, 10 percent of African Americans," says Ellen Wu, the executive director of the California Pan-Ethnic Health Network (CPEHN). "That's compared to five percent of the white population."
Wu says there's a gap in access to care too. That's why the Supreme Court decision upholding the Affordable Care Act is such a watershed moment for her.
She says of the three million Californians who will now be eligible for coverage through the state's health benefit exchange in 2014, two-thirds come from communities of color.
"For example with diabetes ... they’ll be able to get screened earlier and prevent it. And when they do have onset they’ll be able to manage their care better and stay healthier," said Wu.
The same goes for asthma, she said. "We know that for communities of color, they can show up in the emergency room for an asthma attack at higher rates than whites so the free preventive care under the Affordable Care Act (ACA) is really, really critical to keeping our communities healthy."
The news of the decision was especially welcomed among the state's Indian tribes. It turns out that folded into the ACA was a provision updating and making permanent a 1976 law on health care for American Indians and Alaska Natives.
Indians leaders had been working for fourteen years to get the law - called the Indian Health Care Improvement Act - reauthorized, and some people wanted it approved as a stand alone legislation.
Some of the updated provisions include giving authorization for hospice and assisted living care and establishing comprehensive behavioral health prevention, and treatment.
In response to the decision James Crouch, the executive director of the California Rural Indian Health Board, said it gives them confidence in their "efforts to establish a Low Income Health Program for our tribal communities and ensure successful implementation of some of the key improvements to the Indian Health Care Improvement Act."
For many advocates, today was decades in the making.
Remember Health Reform efforts, Act I? Ellen Wu says CPEHN was founded in the 1990's back when the Clinton administration was working on the issue.
"To see it 20 years later be able to... to come to fruition, is really an amazing experience."
Wu got choked up. "It’s the biggest thing that happened since the 60s, with Medicaid and Medicare and we get to be a part of it. it’s really exciting."