This article reviews research pertinent to mental health services under several U.S. health care reform proposals. Issues examined include the redistributional impact of the inclusion of outpatient mental health benefits, optimal benefit packages, and findings that mental health services lower medical utilization costs. It is argued that extending a minimalist model of time-limited benefits, similar to that implemented in most managed care programs, to a national health care insurance plan would perpetuate the current two-class mental health care system.