PITTSBURGH -- There are almost 800,000 adults in Pennsylvania who have no health insurance.

These aren't people who are unemployed; in fact, 71 percent of those without insurance have jobs.

Many are employed by small businesses whose owners say when the rates skyrocket they can no longer afford to be covered.

Nancy Reader and her husband Jim ran the Hearth and Home Furnishings store in Zelienople together until last year.

That’s when Jim was diagnosed with cancer.

He died just 10 months after the diagnosis.

The loss of her husband was devastating, but Reader got another big shock when she got a notice from her insurance company.

The insurance premiums for her and her nine employees skyrocketed.

Reader said, “The new rate per person was going to be $527, which calculates to an 86 percent increase per person.”

Reader said she believes the big rate hike was a result of her husband’s illness.

Many small businesses run into the same problem because insurance rates are based on the number of employees a company has.

The smaller the number of workers, the smaller the risk pool and often that means a higher premium.

Jessica Seabury is director of the Consumer Health Coalition a nonprofit group that helps the uninsured and underinsured get benefits.

She said if you work for a small business you are much more likely to be uninsured or underinsured.

Seabury said, “If someone were to become ill or get sick in a large business there are more healthy employees to counterbalance or pay for that sick employee. When large businesses go to negotiate with insurance companies they have, based on economies of scale, they have more negotiating power because they have more employees or more members to offer to the health insurance company.”

Congressman Jason Altmire said health insurance rates for everyone should be set by using a much larger group of people no matter what the size of the workplace.

He also said it shouldn't make a difference if one person is sick when it comes to setting rates.

Altmire said, “The insurance industry is not going to be happy with that alternative because that's the way they make the money, they wait until you get sick or injured and then drop you.”

Seabury said Pennsylvania has one big problem many other states do not.

“Our insurance commissioner doesn't have a lot of power right now to regulate health insurance rates.”

But a health care reform plan proposed by Governor Ed Rendell would change that.

Seabury explained, “It would require insurance companies, before they raise rates on a particular plan, to go before the insurance commissioner and get that approved. Rendell's plan for small businesses would also prevent insurance companies from discriminating on the basis of pre-existing conditions or illness."