New York City Housing Authority (NYCHA) tenants’ health are put at risk by the policies and practices of the government. Public housing tenants receive unequal treatment when compared to tenants in private housing in obtaining repairs and preventing dangerous conditions. These conditions include lead, lack of heat and hot water, and mold which can have lasting consequences to those forced to suffer in the only home they can afford. This article argues lower rent does not mean lower expectations for tenant safety. After examining the history and regulatory structure that has led to this disparate treatment, the article stresses the importance of future NYCHA reform including greater funding, transparency, accountability, and equality to ensure decent, affordable housing for all.