More than 400,000 Californians had ever enrolled in California’s Low Income Health Program (LIHP) as of March 2012. These LIHP enrollees, who would otherwise be underinsured or uninsured, now have access to services through their county’s safety net facilities and contracted providers. This policy note highlights innovative and successful strategies for outreach, enrollment, and redetermination and retention, as well as the challenges faced by LIHPs.