June 14, 2017 – Many of the national policy discussions today are focused on who will be covered and the scope of benefits consumers will receive. Unfortunately, as important as these issues are, neither of them in any way addresses the underlying issues of high health care costs and the highly variable quality of care in the United States. To foster sustainable reform, we need to focus on promoting high-value care, which means we need to address not only insurance coverage but also reform of the delivery system. Covered California, a state health insurance exchange, has taken advantage of its role as a purchaser to work with health plans and clinicians to implement policies to emphasize and enhance the role of primary care. The evidence supporting the health- and value-promoting influence of primary care is well established. The Patient-Centered Primary Care Collaborative publishes an annual summary of the evidence, which has grown progressively more solid, demonstrating that investment in primary care is key to improving health care delivery that can achieve better care at a lower cost.