As artificial intelligence (AI) is rapidly integrated into healthcare, ensuring that this innovation helps to combat health inequities requires engaging marginalized communities in health AI futuring. However, little research has examined Black populations’ perspectives on the use of AI in health contexts, despite the widespread health inequities they experience–inequities that are already perpetuated by AI. Addressing this research gap, through qualitative workshops with 18 Black adults, we characterize participants’ cautious optimism for health AI addressing structural well-being barriers (e.g., by providing second opinions that introduce fairness into an unjust healthcare system), and their concerns that AI will worsen health inequities (e.g., through health AI biases they deemed inevitable and the problematic reality of having to trust healthcare providers to use AI equitably). We advance health AI research by articulating previously-unreported health AI perspectives from a population experiencing significant health inequities, and presenting key considerations for future work.