OBJECTIVES: China and the United States have approved massive healthcare reforms seeking to increase access to affordable healthcare services. Both countries employed a composite of government programs and private enterprises designed to improve efficiencies in their healthcare markets. This study compares the results of these healthcare reforms so far, explores the longer-term prognoses and considers how lessons learnt can inform healthcare reform elsewhere.  METHODS: In the U.S., 80 MCOs and 240 physicians were surveyed about their participation in reform programs. Quarterly data on the uninsured and healthcare cost trend data were also assessed. In China, 670 patients were surveyed regarding their access to a healthcare provider. RESULTS: Early returns show mixed results that stem from policy decisions inherent in the original programs as well as from national political considerations. Overall, both the U.S. and China healthcare reforms are enjoying success but have shortcomings. In the U.S, partisanship, technology issues, and implementation uncertainties have undermined the reform legislation. However, the nation’s uninsured rate declined from 17.1% in Q4 2013 to 13.4% in Q2 2014, and the healthcare cost trend has fallen. Moreover, the predicted spike in emergency room utilization has not yet appeared. In China, the percentage of citizens with coverage increased from 30% in 2003 to 95% in 2011, while patients’ share of out-of-pocket costs fell. However, improvement is felt less in rural regions and demand for services is increasing. Consequently, Chinese citizens still have difficulty accessing healthcare providers, which, combined with inadequate reimbursement rates, means healthcare in China remains suboptimal. CONCLUSIONS: Together with early coverage statistics, responses from both the U.S. and China to challenges in their respective healthcare reform efforts indicate that long-term success is achievable. Their experiences underscore the need for political unity, substantial financial investments, and adaptability when faced with obstacles and suboptimal results.