Rate hikes for individual health insurance have been big news in states like California and Massachusetts, where premiums increases have been contested by legislators.

But small business health insurance buyers often suffer alongside those in the individual market because they don't have the bargaining power of bigger corporations.

And that's exactly the story at Boston.com, where health care costs are predicted to heavily impact the small business health insurance premiums in Massachusetts.

Dealing with the double-whammy of a bad economy and rising healthcare costs, many employers are struggling to pay for insurance without eating up all their profits.

In some cases employers are offering deductibles, which mean lower premiums but higher out-of-pocket costs. Others have tried sharing more costs with employees. But when an individual policy purchased through small business health insurance can cost up to $600 per month, per employee, neither employer nor employee can easily afford the costs.

Some small business owners are looking forward to 2014, when insurance cooperatives will theoretically offer small business health insurance at more affordable rates.

But that's four long years away, and in the mean time the rising costs of health care are a heavy burden to bear for business owners who need to count every penny.