— We study a microfinance program that provides compulsory health insurance to its borrowers and their spouses. We find that non-borrowing spouses are less likely to file insurance claims than those who are borrowing. Further, a man is more likely to use the health insurance acquired through his wife’s loan than is a woman (through her husband’s loan). These patterns suggest that women who do not borrow are disempowered relative to those who do. 2011 Elsevier Ltd. All rights reserved.