While Affordable Care Act premiums are going to rise in 2026, a post on X from a United States senator saying costs will increase 235% in South Dakota if tax credits expire is misleading. Sen. Tammy Duckworth, D-Illinois, posted that premiums in red states would increase by as much as three times. The proposed rate increases for South Dakota insurers: Avera (8.9%), Sanford Health (5.2%) and Wellmark of South Dakota (1.2%). Nationally, the median proposed increase is 18%. KFF estimates that a family of four making $90,000 will have premiums increase by 56%.