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It’s important for people with serious mental illnesses, including those who rely on the public mental health system for services, to know how the health care reform law will affect them. After health reform, will they have better access to the services and supports they need to recover? The Affordable Care Act, the health reform legislation passed by Congress in 2010, addresses both the lack of access to health care and the quality of the care that is provided in both public and private health systems.  The law will offer significant new options for people with mental illnesses and affect their ability to integrate fully into their communities. However, this law does not directly address the current failings of the public mental health system. This paper examines the health reform law and its impact on opportunities for community integration for people with psychiatric disabilities.