We revisit the question of the role health insurance coverage played in increasing use of Skilled Birth Attendants (SBA) at delivery in Rwanda. Previous studies have suggested that enrollment in Mutuelles health insurance increased the odds of using an SBA by up to 163%. We take advantage of latest Rwanda Demographic Health Survey (RDHS 2010) to increase the sample size and extend the time frame of analysis to five years (2005 to 2010). We also adopt stronger matching methods to control for model dependence. We find that although enrollment in Mutuelles insurance increases use of SBAs at delivery, the size of the effect is orders of magnitude lower than previously published (12 to 18 percent versus 78 to 163 percent). We also find that the effect of education on use of SBA is similar in magnitude and direction as that of Mutuelles insurance enrollment. Our findings lead us to conclude that Mutuelles only had a modest effect on increasing use of SBA at delivery and therefore insurance alone may not be the “magic gullet” that solves the problem of non-use of SBA at delivery