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We examine how future changes in water yield and demand will affect the likelihood of water shortages and the efficacy of some of the most common methods for dealing with water shortages and meeting municipal demands, including improvements in water use efficiency and transfers of water between sectors of the economy. We find that more than 45.8 million people, primarily in the Southwest, central Great Plains, and southern California, would already be experiencing regular water shortages in the absence of groundwater mining. By 2060, that number would grow to over 136.2 million people. Among the reasons we find for increased likelihood of water shortages, reduced water yield is the most prevalent, affecting 80% of water basins in the US In the American West, nearly half of the water basins are projected to see an increase in shortages. We estimate future water withdrawals in the industrial and commercial and thermoelectric sectors will remain fairly steady, but withdrawals in the domestic and public sector are expected to rise. The Colorado River and Rio Grande regions see the largest percentage increases in projected domestic and public water use as well as the greatest percentage decreases in projected water yield. To cover new municipal demands, transfers from agriculture may be needed, in which case, significant impacts to agriculture will occur in northern New Mexico, parts of Utah, Nevada, and Washington where municipal demands are projected to grow to 25%-50% of agricultural water use. The situation is more extreme in northern Arizona and eastern Texas, where additional municipal demands are projected to be six times the amount used by agriculture.