L.D. Schmidt is a working man who arrives, in sickness and in health, at his small midtown Sacramento electronics shop to repair audio equipment.

Schmidt lacks health insurance, and hopes that the health care overhaul being debated in Congress will get him affordable coverage without driving up his costs of doing business.

Schmidt's shop is among the tens of thousands of mom-and-pop firms scattered across America, enterprises whose proprietors often can't even afford health insurance for themselves, let alone their workers.

"I just have to keep coming back to work, unless I get so sick and just can't get out of bed," said Schmidt, who operates Ray's Auto Stereo.

His only employee, a 20-year-old who was kicked off his parents' health plan last year, is paid minimum wage and can't afford to buy his own health coverage.

About three in 10 of the state's self-employed don't have health insurance, and nearly 43 percent of those working in the state's smallest firms – those that employ fewer than 10 people – are uninsured, according to the annual Health Care Almanac produced by the California HealthCare Foundation.

Nearly two in five of the state's 7 million uninsured are either self-employed or work for some of California's smallest companies, the foundation reported.

While large companies have the clout to negotiate lower premiums with insurers, individuals and small businesses aren't accorded the same deals.

But pooled together under a proposed insurance exchange, this group would be better positioned to put pressure on insurers to provide lower prices, according to proponents of overhaul legislation. Part of the pressure would come from government, which would oversee the exchange.

Both Senate and House versions of the bill would allow small businesses with fewer than 10 employees to write off as much as half of what they contribute to their workers' health premiums.

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