Enrollment in Affordable Care Act plans has dropped sharply this year — falling by nearly three million people to about 19.2 million. Analysts say steep premium hikes and Congress’ refusal to extend enhanced subsidies are driving the decline. According to KFF, ACA customers are now paying an average of $178 a month, a 58‑percent jump from last year. Deductibles have climbed too — up 37 percent, averaging nearly $3,800. The Trump administration says the drop is tied to widespread healthcare fraud, but industry groups argue families are simply being priced out.