This article develops a comparative analysis of healthcare provision to migrants in the US and in China. It proceeds in three parts. First, we begin by describing the growth of the unauthorized population and trace the evolution of social provision of healthcare to immigrants, highlighting the restrictive nature of federal social provisions and greater autonomy of state and local governments in redefining eligibility criteria in the US. Second, we examine the impact of legal status on healthcare access and utilization among Mexicans, using original data from the 2007 Hispanic Healthcare Survey and the Mexican Migration Project. We find that unauthorized immigrants report the lowest level of healthcare access and utilization. Third, we then outline a China–US comparative agenda, pointing to similarities between the two migrant flows. In China, recent developments of healthcare coverage for both rural and urban populations have increased access to healthcare, but rural-to-urban migrants still report many barriers in receiving care and are often left out of this growing safety net. We then close with a discussion of lessons learned from the US experience and remaining questions for future comparative research.