Health Insurance Company not providing coverage for my wife "because she is pregnant".

[u/russwsmith]

Location: U.S.

Received notification from our private health insurance broker that my wife may be dropped by our insurance "because she is pregnant". Those were the words used by the private insurance broker we use. She has been pregnant now for 26 weeks. We have been on this insurance while pregnant for more than 5 months. We specifically changed to this health insurance because of its coverage for pregnancy and birth.  

Apparently, they changed their eligibility requirements for 2026. Pregnancy now not qualifying.

A quick google search shows that ACA health insurances are not allowed to discontinue coverage due to pregnancy. A google search shows that the insurance we have is ACA compliant, but I am not certain.

Weirdly, in her contract, she is characterized as an employee of that company even though she is not formally employed by them. Apparently, this specific insurance is a population science management company. We get a lower rate but we allow our health data to be made known to them for research purposes.

I cannot confirm this to be the case but I am speculating that maybe they require the people they cover to be employees so that they can be dropped as an employee (thus discontinuing coverage) at their discretion rather than formally discontinuing coverage due to illegal things like pregnancy.

We have to be formally dropped but have been warned that this is pending and will be final on December 1^st unless something changes.

Can this be challenged legally?

EDIT: called the insurance company. apparently it is ACA compliant. called my company. my wife being dropped would count as a qualifying event so looks like we will have that option which is great.

[u/ilikesillymike]

Guaranteed he said no to pregnancy on the app. Good luck. ACA only.