Analysis of the National Medical Care Utilization and Expenditure Survey indicates that the poor/near-poor with continuous Medicaid coverage had almost double the probability of use of ambulatory mental health care compared with the poor/near-poor not enrolled in Medicaid. The higher probability of use reflects the impact of increased financial accessibility to needed mental health services and may also be influenced by an associated demand for social services provided by organized mental health settings in addition to clinical services. Intensity of use per user was not significantly different between Medicaid- and non-Medicaid-enrolled poor/near-poor, but the percent paid out of pocket was substantially lower for those continuously in Medicaid.