This study presents findings from a survey and interviews investigating library-led textbook affordability initiatives in the United States. The results document diverse considerations and divergences in workflows, challenges librarians face in establishing and maintaining textbook affordability programs, and the intersection of these initiatives with library and institutional strategies. Findings suggest that these programs have grown in number and scale over the past few years, accelerated by the COVID-19 pandemic lockdowns, and are sustained--even without permanent, designated funding--due to consistently positive perceptions about their impact on student success, just-in-time delivery, and alignment with library and institutional goals.