Microfinance institutions have started to bundle their basic loans with other financial services, such as health insurance. Using a randomized control trial in Karnataka, India, Research Paper #37 evaluated the impact on loan renewal from mandating the purchase of actuarially-fair health insurance covering hospitalization and maternity expenses. Bundling loans with insurance led to a 16 percentage point (23%) increase in drop-out from microfinance, as many clients preferred to give up microfinance than pay higher interest rates and receive insurance. There was no adverse selection in insurance enrollment, but only because there was a total absence of demand for health insurance. Further, the decrease in microfinance loan renewal reduced clients' access to credit and had negative impacts on their businesses.