When you get sick, you go to a doctor. But when you get sick of how much it costs you to go to a doctor, where do you go?

There’s no doubt that affordable health care continues to be one of the major political and economic issues in this country for families and small businesses alike. Major changes are already afoot since the Affordable Care Act was signed in March of 2010, and after the Supreme Court’s decision to uphold this act last month, even bigger changes are set to take effect in 2014.

The changes and complexities can feel onerous and incredibly overwhelming, especially for some small businesses. However, they’re certainly worth looking into if you hope to get good coverage at an affordable price (and even save some!) for your employees.

Here are four ways that may help you secure more affordable healthcare coverage for your small business:

1. High Deductible Health Plans Combined With a Health Savings Account (HSA) or a Health Reimbursement Account (HRA)

With a high deductible health care plan, employees are incentivized to think more cautiously about health spending. To balance out this greater out of pocket spending, some small businesses offer HSAs which allow employees to use pretax dollars to pay for uncovered medical costs. Any unused funds in their HSAs can be carried over to the next year, and can be funded by the employee, employer or both.

An alternative to HSA's, HRA's are funds which an employer sets aside in order to reimburse an employee’s deductible or out of pocket expense up to a certain limit. Unused funds, which technically still belong to the employer, can also be carried over to the next year.

2. Increased Bargaining Power

Small companies can also join together to purchase health coverage through cooperatives, which can increase their bargaining power with insurance companies. Results vary by region and cooperative, and while there’s no guarantee that open market rates will be more expensive, this can sometimes be a useful strategy.

3. Using an Insurance Broker

Since most small business owners barely have time to breathe, insurance brokers can take the stress off of doing all the research yourself.

Brokers can help compare plans by explaining the differences, advantages, disadvantages and costs between policies, and can even act as an advocate for your company if you run into problems. Best of all, broker services are free to consumers since they make commissions from the agencies they work for.

4. It’s Still a Market After All

In an interview with the New York Times, Dr. Jeffrey Kullgren gives a few tips on how to get (financially) personal with your doctor in order to negotiate a better price and determine an affordable health care regimen.

Since nobody enjoys dealing with insurance companies, doctors and hospitals are, more often than not, fairly open to negotiating directly with patients. Speaking with a hospital’s billing department or a doctor’s office manager before an appointment is always a good way to see how open they are to negotiating. You never know!

Need some more information to help decide what route is best for your small business? Check out the Small Business Administration’s Health Care & Health Care Reform section for a slew of resources and articles to get you started.