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Little is known about the effect recent health care reform legislation will have on coverage of individuals with severe mental disorders. The authors examined current and predicted sources of insurance coverage and use of mental health services among adults with and without severe mental disorders and modeled postreform changes.

The authors obtained sociodemographic, health status, mental health care use, and insurance coverage data from the 2004–2006 Medical Expenditure Panel Surveys to estimate changes that will occur after reform is fully implemented in 2019.

Adults with severe mental disorders, identified as self-reported severe depression or other psychological distress, were more likely than those without such disorders to be uninsured (21.0% compared with 16.5%). Only one-fifth of individuals with severe mental disorders who lacked full-year insurance coverage had …