We highlight a worrisome situation in American cities—rising water bills that growing numbers of residents cannot afford to pay, leading to water shutoffs. A study of each state’s two largest water utilities suggested fifteen million Americans experienced water shutoffs in 2016. We describe how utility responses to financial challenges facing older cities have caused shutoffs that disproportionally hurt low-income customers. We present new data from public records requests illustrating the scale and distribution of shutoffs in Baltimore, Philadelphia, and Detroit, and discuss the potential of income-based pricing to solve the water affordability challenge.