Reaching the sustainable development goal for water and sanitation access will require significant investments. For some utilities, the private sector or blended public–private investments offer opportunities to expand and improve services, but this is not an option for many utilities serving the poorest households. These utilities are often unable to cover their current operations and maintenance costs and have limited capacity to increase tariffs in order to do so. Yet supporting these utilities is crucial to expanding access to safe drinking water for the majority of citizens. We argue that a new solution is needed to provide utilities serving the poorest with sufficient subsidies to cover their operational costs, stabilize service, and make performance improvements to advance towards sustainable operation. This article presents a potential solution which blends funding from global philanthropy, solidarity levies, and local matching funds. Such a fund, if structured to reflect the principles of results-based funding, transparency, sustainability, and performance improvement, can make a meaningful impact on water access.