Maintaining and rebuilding aging water infrastructure across the United States is essential to providing communities with safe drinking water. Regular infrastructure repair work, such as when a water main under the street is repaired, can disturb service lines, which poses an issue when the line is made of lead. The best approach to prevent lead from leaching into the water is to take special precautions when disturbing lead pipes and to fully replace the lead service line (LSL) to protect residents. Typically, water utilities expect households to pay to replace the portion of the LSL on private property to avoid a partial replacement, which can significantly increase short-term lead in water levels and fails to provide the long-term lead exposure reductions provided by full replacement. Since low-income households may be unable to pay, this practice raises health equity and environmental justice concerns.