This concluding chapter frames the “Madison Declaration” on the future of drinking water in America. The Safe Drinking Water Act’s (SDWA) greatest triumphs have also produced its most pressing modern challenges. After half a century of dramatically reducing the most serious risks to safe drinking water, the SDWA now drives a regulatory treadmill in which federal agencies pursue ever more marginal contaminant reductions while local utilities struggle to maintain the basic infrastructure that makes safe water possible. The chapter illustrates how this imbalance creates mounting financial strain, operational vulnerability, and widening inequities, especially for small and rural communities. It also highlights overlooked risks such as aging infrastructure, workforce shortages, and cybersecurity, all of which fall outside the SDWA’s narrow statutory frame. Against this backdrop, the chapter explains why members of the Water & Health Advisory Council crafted the Madison Declaration: a call for a more holistic, flexible, and sensible approach to drinking water policy. Setting the stage for the Declaration that follows, the chapter invites readers to imagine a future in which regulatory ambition is matched by system resilience, and in which every community can depend on safe, reliable tap water.