A series of proposals at the federal level have focused on Medicaid, the healthcare coverage program for low-income people that goes by the name "Medi-Cal" in California. There has been an intense focus, in particular, on the budgetary cost of coverage through this program. Therefore, whether one believes enrollment in the program needs to be expanded or curtailed, it is essential to increase the affordability of the care that the program finances. This brief lays out some key statistics and considerations—particularly related to the impact of Medi-Cal on the state economy—that policymakers should take into account. It also advances a series of policy recommendations aimed at increasing both the quality of the care Medicaid finances, as well as the fiscal sustainability of the program.