January 20, 2026

Illinois is facing a lead crisis that continues to harm children and families across the state, especially in low-income Black and Latino communities.

In a new op-ed published by Crain’s Chicago Business, our Executive Director Wendi Wilkes makes the case for expanding Illinois’ Medicaid Section 1115 Waiver to cover certified lead-reducing water filters for households with lead service lines.

Crain's Chicago Business: Opinion: Illinois has a lead crisis. Medicaid can help fix it now.

By Wendi Wilkes

January 13, 2026

Illinois is facing a public health crisis that doesn’t make headlines every day, but it flows into kitchen sinks, baby bottles, and drinking water across the state.

With hundreds of thousands of lead service lines, Illinois has the highest number of toxic pipes of any state in the country. These pipes run beneath our homes and our schools, and they are overwhelmingly concentrated in low-income, Black, and Latino communities that have long faced the compounded effects of disinvestment and environmental injustice.

There is no safe level of lead exposure, especially for children and pregnant women. Yet thousands of Illinois families are still drinking and cooking with contaminated water that can be harmful to our health, even at low levels. Lead exposure can cause irreversible developmental delays, learning and behavioral challenges, and increased risk of chronic disease.

Illinois is committed to the essential work of replacing every lead service line – in large part thanks to the historic federal infrastructure funding that is sending hundreds of millions of dollars to the state. Under today’s timelines, communities with the largest concentrations of lead pipes could be waiting decades for full replacement. Chicago, for example, is likely to receive an extension that could stretch its deadline for lead pipe replacement to 2047. Expecting families to wait that long for safe drinking water — especially those who have already borne the brunt of environmental harm — is simply unacceptable.

The state has a practical, proven way to protect people now, while that long-term work continues. Expanding the state’s Medicaid 1115 Waiver to cover certified lead-reducing water filters is the most practical, targeted, and equitable step Illinois can take right now to reduce exposure in high-risk homes.

We already know this approach works and that success is rooted in leadership from Gov. JB Pritzker and the Illinois delegation, who have been champions to remove lead pipes from our homes and ensure clean drinking water for all families. In Cook County, a pilot program earlier this year used state Medicaid dollars to provide 90,000 households at the highest risk of exposure access to certified lead-reducing water filters through redeemable vouchers. Nearly 9,000 households redeemed free certified filters that they didn’t have before and, for many, couldn’t otherwise afford. For those families, that’s meaningful, concrete protection from lead exposure every time they turn on the tap.

Expanding the Medicaid 1115 waiver statewide would direct resources into the low-income, Black, and Latino communities where lead pipes are most prevalent, and it would do so in a way that is consistent with what public health experts already tell us to do. Federal guidance from the EPA and CDC recognizes certified lead-reducing water filters as an important tool to prevent lead exposure when service lines are still in place.

A modest investment in filters today can help avoid enormous public health and economic costs down the road. And the costs of untreated lead exposure show up everywhere in our health care, education, and government service systems — including in cognitive impairments, behavioral health care, pregnancy complications, long-term chronic illness, and in the strain on families and communities.

 
Research has found that every dollar spent on preventing lead exposure yields at least $17–$221 in future savings. For Medicaid managed care organizations, the calculus should be even clearer. Their model is built on the idea that preventing serious health problems is better and cheaper than treating them after the fact. Covering certified lead-reducing filters for households with lead service lines is textbook preventative intervention.

The question facing Illinois leaders right now is not whether we understand the scope of the problem — it’s whether we are willing to use the tools we already have to address it. Expanding the Illinois Medicaid 1115 Waiver to cover lead-reducing water filters for Medicaid households is an actionable step the state can take right now to protect people from irreversible harm, deliver tangible environmental justice to underserved communities, and save money over the long term by preventing the worst health outcomes from lead.

No child in Illinois — or anywhere — should have to wait more than two decades for safe drinking water because they live in a low-income household or in a neighborhood with aging infrastructure. Illinois has more lead pipes than any other state, but we also have an opportunity to lead in how we respond. Expanding the Medicaid 1115 waiver to cover certified filters will not solve the entire crisis — but it’s the fastest and fairest way to give families most at risk the strongest protection now.