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α: calibrated so average coauthorship-adjusted count equals average raw count
We document large gender disparities within a government program that entitles 46 million poor individuals to free hospital care. We show that care is not free in practice and higher costs are associated with larger disparities. Lowering care costs increases female utilization but does not reduce gender disparities because marginal beneficiaries are as likely to be male as inframarginals. Long-term exposure to local female leaders reduces disparities by addressing factors lowering female care. In the presence of gender bias, subsidizing social services may fail to address gender inequalities without actions that specifically target females.