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Seamstress Peggy McPhee has worked at a Santa Rosa bridal shop for 20 years. She has a good relationship with her boss, but the owner, like many small business people, simply can't afford to pay for Peggy's health insurance. So Peggy, 51, has fended for herself.

Until now, she has always gotten by. It was easier back in the early 1980s when her husband, now her ex-husband, worked at Sonoma State University, which covered their health needs. When they divorced she went on to a Kaiser conversion plan. She was able to make the payments, and Kaiser was easy to deal with. "They were pretty easygoing back then," Peggy says.

But rates began to creep up, and this year it was no longer a creep; it was a full gallop. Her premium jumped from $300 a month to $490, her co-pays escalated, hospital rates climbed. It was a devastating blow to someone who, like Peggy, has to watch every penny.

"I was very angry," she says. She went to Kaiser's health plan office, which said there was no mistake about the numbers. She does not qualify for Medi-Cal. Other plans are out of the question because she has pre-existing conditions.

She doesn't know where she can cut back this time. She dumped her cell phone last year, and endured the winter without turning on the heater. "I bit the bullet," Peggy says. "But now, it's just out of reach. I can't afford this now. I don't know where the $190 is going to come from."

Ironically, the added financial pressure has worsened her physical condition by giving her irregular heartbeats. That's not the worst of it, though: it is the discouragement. "It's gotten me depressed," Peggy says.

How will Peggy adjust to this unconscionable rate boost? She simply doesn't know.