Forgoing food; Cutting back on utilities; Driving less; Borrowing money....

These are the sacrifices that tens of millions of people are making to afford their health care expenses, according to a West Health-Gallup Center on Healthcare in America survey released Thursday.

Roughly one-third of respondents – equivalent to more than 82 million Americans – said they have had to cut back on at least one daily living expense to cover their health care bills, according to the survey of nearly 20,000 adults, which was conducted from June through August.

The report is among the latest examples of the affordability crisis plaguing Americans who are struggling to afford the cost of living amid stubbornly high prices for food, housing, utilities and other necessities. And it comes at a time when health care spending is on the rise, in part because the country’s health is on the decline, said Tim Lash, president of West Health, a nonprofit group focused on health care delivery and affordability.

“It’s not just that health care is expensive,” Lash said. “It’s that we use more and more health care as Americans.”

Sheila Nesbit, who recently retired after a long career as a librarian, is among those having to make tough choices. She didn’t realize that Medicare would cover less than her job-based insurance plan did. So when her doctor recommended new orthopedic shoe inserts costing roughly $250 to help with pain while walking, she decided not to buy them, and she’s also looking for discount cards to help her purchase a $90 medicine that Medicare doesn’t cover.

What’s more, she sometimes skips lunch and doesn’t always take her medicines for cholesterol, asthma and high blood pressure so she can save money. And she’s lowered the thermostat at home, opting to put on a sweater and huddle under two blankets to ward off the cold.

“I never thought I’d be living like this,” said Nesbit, 65, who lives in the Chicago suburb of Park Forest.

Although the uninsured and those lower on the income ladder have to make more tradeoffs, they aren’t the only ones having trouble affording their health care expenses.

“Even middle-class and upper-middle-class Americans are still having to make decisions like cutting back on utilities, driving less, borrowing money to pay for health care,” Ellyn Maese, research director for the West Health-Gallup Center on Healthcare, told CNN.

Health care costs have also prompted tens of millions of Americans to postpone major life events in recent years, according to a separate West Health-Gallup Center survey conducted between October and December. Just over a quarter of respondents said they delayed surgical or medical treatment, while 14% held off buying a new home, and just under a tenth put off retirement.

The situation will probably get worse in the coming months and years; millions more people are expected to become uninsured after Republican lawmakers last year approved more than $1 trillion in cuts to federal support for health care and after Congress allowed the enhanced Affordable Care Act premium subsidies to expire at the end of last year.

“If people are losing their insurance,” Maese said, “we’ll see more people facing even more of these tradeoffs.”

Paying for health insurance, doctors' visits, prescription drugs, procedures and other health care expenses are among Americans' biggest financial headaches.

Many people find they have to make tradeoffs to cover their health care bills, including not taking their medication as prescribed, borrowing money and skipping meals.

Are you having to make financial trade-offs to afford health care? Or are you forgoing health insurance or needed care because of the cost?

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