In a large saucepan, cook sausage over medium heat until no longer pink; drain, remove from pan and set aside. In the same pan, saute onion in oil until tender. Add garlic; saute 1 minute longer. , Add the water, beans, tomatoes, broth, macaroni and pepper; bring to a boil. Cook, uncovered, until macaroni is tender, 8-10 minutes. , Reduce heat to low; stir in sausage and spinach. Cook until spinach is wilted, 2-3 minutes. Garnish with cheese.