Public health insurance for China’s children is analyzed using an equity analysis framework and compared to US public health insurance for low-income children. Four dimensions of comparisons are addressed: fairness of financial support, equal treatment for equal need, equality of access to services, and equality of health outcomes. Secondary data from China and US government statistics were used for the comparisons. Recommendations to strengthen China’s health insurance for children include lower out-of-pocket expenses, standardized data collection and management, qualified nurse practitioners providing rural health care, and explicit coverage requirements.