In January 2021, Manatt Health described ten health care imperatives essential for improving our health care system and advancing health equity in the decade of the ’20s. Our 2022 update, “Navigating Through the Surges” recognized the extraordinary challenge of simultaneously improving the health care system while navigating the exigencies of the pandemic, and highlighted the problems presented by erosion of trust, the epidemic of behavioral health disorders, persistent and widening disparities, and chronic workforce shortages and stresses. We recognized gains made through federal and state action to improve coverage and access and industrywide attention to addressing inequities.