Since becoming operational in 1977, MCHA has served as an insurance safety net for Minnesotans who have been turned down for individual health insurance due to pre-existing conditions. There are many different circumstances that cause Minnesotans to turn to MCHA. These circumstances include, among others:

• Self - employed individuals who want insurance but are rejected due to pre-existing conditions
• Individuals who exhaust COBRA benefits
• HIPAA eligible persons (generally, persons leaving employer group coverage)
• Spouses and dependents of employees whose employer does not offer dependent health care coverage
• Individuals eligible under the Trade Adjustment Assistance (TAA), alternative TAA, or Pension Benefit Guaranty Corporation (PBGC).
• Changes in self-insured employer or union plans (changes in benefits, cancellation of benefit plans, or coverage for retirees under 65 year of age)
• Persons reaching lifetime maximums in their insurance policies
• Persons reaching lifetime maximums in their employer’s self-insured plans
• Individuals working for employers who do not offer health insurance benefits
• Individuals laid off or terminated by self-insured employers who do not offer conversion policies
• People waiting for employer coverage while fulfilling probationary employment period
• People who had individual health coverage or group coverage that was cancelled by their insurance company
• Former employees of bankrupt companies
• Former insured's of HMOs or insurance companies that become insolvent
• Recipients of the Minnesota Health Department’s “Minnesota Children With Special Needs” program
• Some recipients of Ryan White funding