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AT&T Retirees Face ACA Premium Shock—Here’s How Others Are Responding

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Healthcare Provider Update: Healthcare Provider for AT&T: AT&T collaborates with multiple healthcare providers to ensure its employees receive quality health coverage. One primary partner is UnitedHealthcare, which offers health plans tailored for AT&T employees. Potential Healthcare Cost Increases in 2026: As the landscape of healthcare evolves, AT&T employees may face significant challenges with rising healthcare costs in 2026. Experts anticipate a steep surge in premiums for Affordable Care Act (ACA) marketplace plans, with some states projecting increases exceeding 60%. This rise is largely attributed to the potential expiration of enhanced federal premium subsidies and soaring medical expenses. Without action from Congress to extend these subsidies, over 22 million enrollees may see their out-of-pocket costs increase by more than 75%, making it imperative for workers to prepare financially for the coming changes. Click here to learn more

'AT&T employees approaching retirement should recognize that proactive income and health care planning can make the difference between preserving subsidy eligibility and facing sharply higher ACA premiums.' – Paul Bergeron, a representative of The Retirement Group, a division of Wealth Enhancement.

'AT&T employees planning their retirement should consider how income levels influence ACA subsidies, as even small adjustments in taxable withdrawals can affect future health care affordability.' – Tyson Mavar, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article, we will discuss:

  1. How the expiration of enhanced ACA subsidies after 2025 could impact health care costs for retirees and early retirees.

  2. Real-life case studies illustrating how different individuals are adjusting to rising ACA premiums.

  3. Practical steps AT&T professionals can take before enrolling in 2026 Marketplace plans.

by Brent Wolf, CFP®, Wealth Enhancement

As open enrollment for 2026 Marketplace plans begins, many households are seeing dramatic shifts in their renewal letters. Rising base premiums and the possible end of enhanced subsidies after 2025 could mean significantly higher out-of-pocket costs for anyone purchasing coverage through the Affordable Care Act (ACA) exchange.

The Kaiser Family Foundation (KFF) estimates that if Congress does not extend enhanced premium tax credits, average net premium payments could more than double in 2026. 1

“It feels like a second mortgage to pay this premium.”

Profile:  A couple in their early 60s who retired a few years before becoming Medicare-eligible.

What changed:  Their ACA premium had been manageable due to increased subsidies. Their renewal now indicates a rise of about $1,000 to $1,200 monthly if enhanced credits expire.

Decision pressure:  They faced hard choices—drawing more taxable income from IRAs, going without coverage, or returning to the workforce for employer-based insurance.

Our response:  We reworked their income plan to align with the ACA’s income-based subsidy structure. By controlling their Modified Adjusted Gross Income (MAGI) through smaller IRA withdrawals, use of cash reserves, and partial Roth conversions, we kept them eligible for key subsidies. Comparing a Bronze high-deductible plan with a health savings account (HSA) to a Silver plan revealed the Silver plan—thanks to cost-sharing reductions—was more economical given their expected medical treatments.

“I can’t risk losing coverage while battling an illness.”

Profile:  A single client in her early 60s undergoing ongoing medical treatment.

What changed:  Without enhanced subsidies, her premiums nearly tripled.

Decision pressure:  Balancing affordability with the need to keep her care team and prescriptions consistent.

Our response:  We prioritized staying with her provider network and controlling her out-of-pocket costs. A dedicated “medical reserve” fund—equal to one year’s maximum out-of-pocket limit—gave her a cushion without liquidating investments during market declines. We also worked with her physicians to identify lower-cost prescriptions through her plan’s formulary.

“The new premiums are hurting our business margins.”

Profile:  A self-employed couple—one partner managing asthma and the other a cardiac rhythm condition.

What changed:  Without subsidies, their net premiums are expected to rise sharply.

Decision pressure:  Continue paying high premiums, choose a plan with a very high deductible, or seek W-2 employment for benefits.

Our response:  We compared total annual costs for a Silver plan versus a Bronze option, factoring in frequent specialist visits and prescriptions. Once total medical costs were considered, the Silver plan proved more cost-effective. We also aligned their life and disability coverage and tailored their tax approach to reflect potential changes in premium tax credits.

“I’m young and healthy—do I even need full coverage?”

Profile:  An independent contractor in their 20s with minimal expected medical use.

What changed:  Premiums for mid- and high-tier plans nearly quadrupled.

Decision pressure:  Choosing between a high-deductible Bronze HSA plan and catastrophic coverage.

Our response:  We modeled three options—a Bronze HSA-eligible plan, a mid-tier plan, and catastrophic coverage. The Bronze HSA option offered the best mix of lower premiums and long-term tax benefits. Monthly automated HSA contributions build a future medical fund that can later be used for qualified health care expenses or Medicare premiums (excluding Medigap) after age 65.

Five Steps to Take Before You Enroll

1. Evaluate your total annual cost, not just the premium. Factor in deductibles, copays, and the possibility of reaching your out-of-pocket maximum.

2. Manage your MAGI carefully. ACA subsidies depend on income. Coordinate Roth conversions, capital gains, and IRA withdrawals strategically.

3. Verify your doctor and prescription coverage. Always confirm your plan’s provider network and formulary before enrolling.

4. Maintain a medical reserve fund. Hold six to 12 months of premiums plus a portion of your maximum out-of-pocket in cash or short-term Treasuries.

5. Finalize your plan by December 15. Open Enrollment for 2026 coverage ends on December 15, with plans effective January 1.

If Affordability Is a Concern

Choosing to go without insurance can expose you to serious financial strain in case of illness or accident. Consider the most affordable Bronze plan that still meets ACA minimum coverage requirements. If your income decreases during the year, you may become eligible for Medicaid or CHIP and qualify for a Special Enrollment Period. 2

How The Retirement Group Supports AT&T Professionals

For AT&T employees approaching or already in retirement, the intersection of rising health care costs and income planning can be complex. The Retirement Group focuses on helping clients navigate ACA subsidy rules, tax-efficient withdrawal strategies, and health care cost planning during retirement transitions.

To speak with an advisor about aligning your retirement income and health care planning, call (800) 900-5867 today.

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With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
AT&T offers a defined benefit pension plan with a cash balance component. The cash balance plan grows with annual interest credits and employer contributions. Employees can choose between a lump-sum payment or monthly annuities upon retirement.
Layoffs and Restructuring: AT&T is expanding its $8 billion cost-reduction program, which includes significant layoffs. The company has reduced its workforce by more than 115,000 employees over the past five years, with further cuts expected in 2024 (Sources: TechBlog, WRAL TechWire). Operational Strategy: The restructuring efforts are part of AT&T's broader strategy to improve efficiency and adapt to a maturing market. This includes collaborations with firms like Blackrock to create open-access networks, which could provide new growth opportunities (Source: TechBlog). Financial Performance: Despite these challenges, AT&T reported strong financial results in 2023, driven by growth in 5G and fiber services. Revenues from mobility and consumer wireline segments saw significant increases, reflecting the company's strategic focus on high-growth areas (Source: AT&T).
AT&T offers RSUs that vest over several years, giving employees a stake in the company's equity. They also grant stock options, allowing employees to purchase shares at a set price.
AT&T has consistently updated its healthcare benefits to address the dynamic healthcare landscape and ensure comprehensive coverage for its employees. In recent years, AT&T has focused on enhancing its wellness programs, introducing initiatives like virtual healthcare services and telemedicine, which have become increasingly important during and after the pandemic. These services provide employees with convenient access to healthcare, reducing the need for in-person visits and supporting overall health management. Additionally, AT&T has increased its focus on mental health resources, offering counseling services and stress management programs, reflecting the company's commitment to holistic employee wellness. For 2024, AT&T has made adjustments to its healthcare plans to better align with the rising costs of medical services and prescription drugs. The company has introduced higher contribution limits for Health Savings Accounts (HSAs) and has implemented more robust wellness incentives to encourage proactive health management among employees. These changes are essential in the current economic and political environment, where healthcare affordability and accessibility remain critical issues. By continuously evolving its healthcare benefits, AT&T aims to support its employees' health and financial well-being, ensuring they have the resources needed to navigate the complex healthcare landscape.
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If you have questions about a potential AT&T surplus or would like more information you can reach the plan administrator for AT&T at p.o. box 132160 Dallas, TX 75313-2160; or by calling them at 210-351-3333.

https://www.att.com/documents/pension-plan-2022.pdf - Page 5, https://www.att.com/documents/pension-plan-2023.pdf - Page 12, https://www.att.com/documents/pension-plan-2024.pdf - Page 15, https://www.att.com/documents/401k-plan-2022.pdf - Page 8, https://www.att.com/documents/401k-plan-2023.pdf - Page 22, https://www.att.com/documents/401k-plan-2024.pdf - Page 28, https://www.att.com/documents/rsu-plan-2022.pdf - Page 20, https://www.att.com/documents/rsu-plan-2023.pdf - Page 14, https://www.att.com/documents/rsu-plan-2024.pdf - Page 17, https://www.att.com/documents/healthcare-plan-2022.pdf - Page 23

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