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Many Teachers and Healthcare Workers Can’t Use 401(k)s. It’s Costing Them Dearly.

By David Wignall

September 22, 2025

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A study released by Vanguard shows that employees who invest in 403(b) retirement accounts pay significantly higher fees on average.

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Roughly 10 million teachers and healthcare workers can’t access low-cost investment vehicles thanks to a quirk of their retirement accounts. Frequently required to put their savings into higher-expense plans, they retire tens of thousands of dollars poorer, on average, than identical private-sector employees, according to Vanguard.

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“The cost is considerable,” says Bob Wolfe, a financial planner at HealthyFP who serves healthcare workers. “It’s a shadow cost, though. People don’t usually feel it as much, because it’s automatically debited out of the back of their retirement account.”​

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