Although numerous studies have considered the effects of having health insurance on access to health care, physical health, and mortality risk, the association between insurance coverage and mental health has been surprisingly understudied. Building on previous work, we use data collected from a two-year follow-up of low-income women living in Boston, Chicago, and San Antonio to estimate a series of latent fixed-effects regression models assessing the association between insurance status and symptoms of psychological distress. We find that having any insurance and private insurance is unrelated to depression, anxiety, and somatization. Having public insurance is unrelated to depression and somatization, but there is some evidence that having public insurance is associated with greater anxiety. Although not a direct test of the Affordable Care Act, our results suggest that the expansion of coverage may have a limited impact on symptoms of psychological distress among low-income urban women with children.