There's really not much you can do, Jake. It's the price of living in the boonies as Chuckles has so delicately pointed out. If it's any comfort, you're in a similar boat to my parents... though they get just good enough AT&T GSM reception that they're using a $50 a month/5GB broadband account for internet access. Cheaper than satellite, but the connection is still no good for reliable VoIP service, but it's at least better than the paltry 28.8kbps dial-up they otherwise get, or the low-end EDGE speeds that cap out to 56k dial-up roughly that T-Mo provides.
About the only way I can recommend you cut that fat is to trim down the local phone to the barebones minimum with features and services (even if it means losing caller ID if you haven't ditched it already), and either use a combination of a Google Voice account linked to your home phone for long distance or use a cheaper long distance provider like
Pioneer Telephone for your long distance rates. With enough effort, you can whiddle down the AT&T bill even after all the taxes and fees to between $22-30 a month. Unfortunately, switching "local" carriers almost never saves any money, even if they'll let you.... AT&T takes their pound of flesh to the tune of about $5 a month most areas that never gets disclosed in the initial monthly rate there, too.
