In 1978 the President's Commission on Mental Health called for a national plan for the care of persons with chronic mental illness. The plan was completed and released in 1980, but was never adopted as the policy of the incoming Reagan Administration. Despite changes in attitudes in the 1980s toward the federal government's role in human services and an atmosphere of fiscal restraint, many of the plan's specific recommendations for changes in Supplemental Security Income, Social Security Disability Insurance, Medicaid, and Medicare have been implemented. In this paper, the implementation of these recommendations is analyzed. The authors discuss some of the strategies used by mental health advocacy groups to make gains in the 1980s. Recommendations for the 1990s are discussed.