The Lead and Copper Rule (LCR) addresses lead in drinking water through utility-centric monitoring in high risk homes, corrosion control, and public education. These utility-centric activities, however, do not provide adequate information on lead concentrations in individual homes and leave an unknown number of consumers at risk from drinking water lead. To assess the number of consumers at risk from drinking elevated lead concentrations, we mined 166,554 lead samples taken for LCR compliance in Iowa and developed a new approach for estimating the number of consumers at risk. We estimate that 65,000 ± 14,000 people in Iowa are at risk from drinking water lead above the U.S. EPA action level of 15 parts per billion (ppb) each year. We further explored the average household sampling rates of community water systems (CWSs) of different population sizes, where, overall, 8.6% of homes in an Iowa CWS are sampled. Our estimates indicate that, even in the absence of a lead-in-water crisis, a significant number of people are at risk from lead concentrations exceeding available guidelines, raising concerns about the severity of baseline lead concentrations in drinking water nationwide. Our analysis highlights that consumer-centric lead in drinking water policies and avoidance strategies are needed to ensure public protection.