Racial and ethnic disparities in the health care system have long impeded our nation’s health and well-being. For everyone in the U.S. to achieve their full potential—and for our nation to achieve its full potential—we must ensure equitable access to high-quality health care. This report presents an anti-racist re-imagining of the Medicaid and CHIP programs that actively reckons with the racist history of health care coverage. The report offers recommendations to advance racial equity in Medicaid and CHIP. It also provides principles to guide anti-racist policy transformations that center program participants and their communities.