Sewer Rates Rose 24% in Five Years, Pushing Low-Income Families Into Water Debt

Combined drinking water and sewer bills in the US increased 24.1% from 2019 to 2024, driven by mounting operational costs, inflation, and necessary capital investments in aging infrastructure. In cities like Birmingham, Alabama and Cleveland, Ohio, combined water and sewer bills now exceed the EPA's affordability threshold of 4.5% of median household income. Minimum-wage earners in some cities must work up to 20 hours per month just to cover their water and sewer bills. The downstream effects are dire. An estimated 12.1 to 19.2 million US households lack access to affordable water services, and approximately 20% of US households carry water debt. When families cannot pay sewer bills, utilities can shut off water service entirely, since water and sewer billing are typically combined. Losing water service in a home triggers a cascade: it violates habitability standards, can lead to child protective services involvement, and forces families into emergency shelter or homelessness. The cruel irony is that rate increases are driven by the need to fix the very infrastructure failures that disproportionately harm low-income communities. Cities under EPA consent decrees to fix CSO problems must raise rates to fund billion-dollar remediation projects. The cost of compliance falls on ratepayers, not on general tax revenue, meaning the poorest residents pay the highest share of their income to fix a public infrastructure problem they did not create. This problem persists because water and sewer services are funded almost entirely through user fees rather than general taxation. Unlike roads, schools, or public safety, which are funded through progressive tax structures, sewer services operate on a regressive fee model where every household pays roughly the same bill regardless of income. Federal low-income water assistance programs are nascent and underfunded compared to energy assistance programs like LIHEAP, which has existed since 1981. There is no equivalent federal safety net for water and sewer affordability.