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WASHINGTON (Reuters) - When Jim Hann learned he would be laid off, he scheduled surgery to donate a kidney to his wife.
Steve Drake rationed his asthma medicine after he was let go while two-time cancer survivor Roberta Furchak had to draw on precious retirement savings to ensure her tests were covered after she lost her job.
All three were trying to compensate for losing health insurance in a country where unemployment often means going without coverage.
With unemployment rising to its highest level in more than a quarter century, more Americans are confronting the double crisis of losing both their jobs and their employer-sponsored insurance, which covers 177 million people.
Many unemployed Americans say they cannot afford the high premiums insurance companies charge for personal policies. People like Furchak and Drake who have pre-existing medical conditions have a tough time even finding coverage.
A recent study by the Robert Wood Johnson Foundation said the number of uninsured Americans could jump to more than 65 million in 10 years as healthcare costs more than double. The U.S. Census Bureau says about 46 million Americans are currently without insurance.
President Barack Obama has vowed to reform the healthcare industry and lawmakers are struggling to figure out a compromise all can agree on.
Hann, a 51-year-old plant worker from Coolville, Ohio, pushed doctors at Georgetown University Hospital to speed up a transplant operation so he could donate his kidney to his ailing wife Hannah while he was still covered.
"They were kind of dragging their feet -- said she had to quit smoking," said Hann, who found out in January he would soon be laid off from his job at a plastics factory.
"I called and said 'I'm losing my job. I'm going to lose my insurance. We've got to get this done.'"
On February 13, the Hanns had the surgery, even though Hannah, who has had an intestinal transplant and multiple bowel operations in recent years, had not quit smoking.
The couple sold their newly-built house when Jim Hann found out he was being laid off and now rent an older home. Their friends and neighbors have helped raise money to cover the costs of traveling to Washington for treatment, but the combined impact of major surgery, losing his job and worrying about insurance has taken its toll.
"It's just tough sometimes," said Jim Hann, sitting by his wife's hospital bed as a tear slid down his cheek.
"She's my wife. You do what you have to do," added Hann, who faces the prospect of having no insurance once the extended healthcare his employer offered after the layoff runs out.
Furchak of White Lakes, Michigan, keeps hoping for healthcare reform to pass.
"For me, health insurance is the most important thing. I have to have that or I'd lose everything," said Furchak, who after two bouts of lung cancer needs constant monitoring.
Furchak, 60, lost her job last November and opted for a costly continuation of her health coverage under a U.S. program called COBRA, which requires former employees to pay the whole cost of insurance but at least allows coverage to continue for a limited time.
The $430 monthly bill took up a big chunk of her $774 unemployment check, forcing her to dip into retirement savings. Recently Furchak's monthly COBRA bill fell to $150 as part of a subsidy provided under Obama's economic stimulus plan.
This has made a "huge difference", said Furchak, who had part of her lung removed and two rounds of chemotherapy and radiation when her cancer recurred.
Her coverage runs out in May 2010. "When that finishes, I don't know what I'm going to do," she said.
"At that point I might very well have to make the decision not to carry insurance until my Medicare kicks in," she added, referring to the health program for the elderly and disabled that covers Americans 65 and older.
"And that's going to be very scary but I don't know what else to do," she said.
Drake often delays taking asthma drugs until his chest starts to tighten.
"I am constantly making a choice," said the 57-year-old from Sherwood, Oregon who worked for a consulting company in financial services until he was laid off last July.
"I put off my medicines until I start to feel it then I get them refilled," said Drake, whose family insurance eats up half his monthly unemployment check.
Drake, who has also been taking money out of his retirement funds to make it to the end of the month, says he cuts some of his pills in half to make them last longer.
A study released by the American Cancer Society Cancer Action Network showed that a quarter of people surveyed who have had a cancer diagnosis have had to delay health care because of costs.
"It's always something," said Drake, who recently tore his rotator cuff but can't afford to get it fixed. "So it's like I'm walking around with one and one-half arms."
Editing by Alan Elsner and Maggie Fox