Everyone, everywhere, deserves access to safe and affordable water. Yet, America’s drinking water and sewer infrastructure are aging and underfunded — and, according to the American Society of Civil Engineers 2025 infrastructure report card, they’re barely earning passing grades. 

More than 2 million people in the United States live without access to the basic necessities of safe water and sanitation, and millions more risk losing access to water due to rising water bills. The longer we wait to address aging and stressed infrastructure, the more expensive this becomes to fix,  pushing the burden onto communities and families.

In December, the Environmental Protection Agency estimated that up to 19 million households — or 1 in 7 people — lack affordable access to water and wastewater services. (Other research suggests this number may be higher.)

We know how to keep families connected to drinking water. The Low-Income Household Water Assistance Program (LIHWAP), passed by Congress and signed by the president, provided water bill assistance to families during a public health crisis and economic hardship. The program successfully prevented nearly 1 million water shutoffs nationwide. It helped more than 3.8 million people, a majority of which included children, the elderly, and those with disabilities or living in poverty. Though meaningful, LIHWAP was temporary and ended a year ago. We need comprehensive and forward-looking solutions to address the growing water affordability crisis.

How did we get here? We built most of America’s water infrastructure more than 50 years ago. Since then, wear and tear combined with growing communities and extreme weather have stressed water infrastructure.

In the 1970s, the federal government contributed 60 percent to water infrastructure spending. By 2023, the share of federal spending on water utilities shrank to 4 percent, shifting the costs to state and local governments and ratepayers, and leaving needed infrastructure repairs unfunded. The Bipartisan Infrastructure Law began to fill some of this gap. Still, it’s a drop compared to what’s needed to update and maintain the water infrastructure.

Utilities and families cannot shoulder this growing burden. From big cities to small, rural communities, we struggle to balance upkeep and upgrade costs with affordability.

Take Martin County, KY, as an example. A 2023 Appalachian Citizens’ Law Center study highlighted how inadequate maintenance and chronic underinvestment in rural water systems in Kentucky have led to unsafe water and high water bills. In Martin County, families are priced out as water rates climb to more than five times the national average. The water and sewer bill for the average Martin County family is more than $150 a month, with the poorest households spending up to 8 percent of their income on water services. 

Not only do people lose access to water when they can’t pay their bills, but it makes it harder for utilities to raise the money they need for maintenance and updates.

The situation in Martin County is not unique. In Michigan, the water and sewer service cost has risen by more than 400 percent for the poorest households since 1986, outpacing wage growth and increasing the number of shutoffs.

In California’s Central Valley, water contamination and scarcity force residents to pay for water twice — once for toxic tap water unsafe to drink and again for bottled or trucked-in water.

The economic toll of water insecurity is immense. The ASCE report card underscores the staggering financial costs of water affordability gaps, estimating  that America’s drinking water systems need more than $625 billion in investment over the next 20 years to recover. According to one estimate, water shutoffs could cost the economy more than $8 billion annually.

The toll is not just economic — it is human. In communities nationwide, people are suffering due to our collective failure to prioritize water access and affordability for everyone.

The Water Equity and Climate Resilience Caucus’s Water Affordability for All policy framework calls for increased federal investment in water infrastructure, a community-driven approach for small, rural and lower-income water systems, and the establishment of a permanent national water assistance program to ensure that no one loses access due to inability to pay.

We owe it to families across America — from Martin County, Kentucky, to Detroit to California’s Central Valley — to make safe, affordable water a reality. By boldly using the funding and policy levels within reach, this is a future policymakers have the power to deliver. By working across political divides and levels of government and hand-in-hand with utilities and communities, we can make transformative changes for everyone’s health and economic well-being.

Mary Cromer is the deputy director of the Appalachian Citizens’ Law Center and a member of the Water Equity & Climate Resilience Caucus’ Water Affordability Workgroup. She wrote this for InsideSources.com.

Yasmin Zaerpoor is the director for Water Equity and Climate Resilience at PolicyLink, which anchors the Water Equity and Climate Resilience Caucus. She wrote this for InsideSources.com.