Guaranteeing Comprehensive, Inclusive Paid Family and Medical Leave and Sick Time

When it comes to guaranteeing paid family and medical leave, the United States is an extreme global outlier.¹ Unlike virtually all its economic peers, the nation does not guarantee any paid leave at the federal level—not to bond with a new child, not to recover from serious illness, and not to care for a seriously ill loved one. To date, 13 states and Washington, D.C., have passed paid family and medical leave laws to address this unmet need, but most states have not.²

As a result, most Americans do not have the paid leave they need.³ This gap creates powerful harmful consequences that fall particularly hard on women, who bear more than their share of caregiving responsibility across the lifespan.⁴ Without the paid family and medical leave they need, many women are forced out of the U.S. labor market, either temporarily or permanently.⁵

Paid family and medical leave would be life-changing for women and working families across the country, as well as the for the U.S. economy. Virtually all workers need time to recover, care, or bond at some point in their lives; all workers benefit from the peace of mind of knowing they will have the paid leave they need in the event of the unexpected. This broad impact likely contributes to paid leave’s overwhelming, nonpartisan popularity: In a January 2023 poll, 79 percent of likely voters reported supporting a federal paid leave program; this includes 74 percent of independent or third-party voters, 72 percent of Republicans, and 92 percent of Democrats.⁶

In addition to existing state-level paid leave benefits, policies to enact paid family and medical leave are now before Congress. At the federal level, they include the FAMILY Act, which would guarantee up to 12 weeks of paid leave. This chapter of the “Playbook for the Advancement of Women in the Economy” details the problem, the economic benefits of resolving it, and the federal and state policy recommendations for doing so.

The problem

Nearly three-quarters of private sector employees, 73 percent, do not have paid family leave to bond with a new child or care for a seriously ill loved one.⁷ For their own serious health needs, 57 percent of private sector employees do not have access to short-term disability insurance through their employer to cover lost income from an extended illness or injury.⁸ While most, though not all, employees have access to some paid sick days, those who have paid sick days have an average of just seven days per year—far short of what is needed for a serious illness or injury.

What’s more, access to paid leave is neither equally nor equitably distributed. In the private sector, women are less likely than men to have access to comprehensive paid leave.⁹ Across the board, low-income workers are disproportionately likely to be left out.¹⁰ Part-time workers also are particularly likely to be excluded, which has important gender equity impacts: Women make up 63 percent of part-time employees even though they represent 47 percent of all employees.¹¹ People with disabilities are notably less likely than people without disabilities to have access to paid leave;¹² women with disabilities are especially likely to lack comprehensive paid leave.¹³

Indeed, many workers are not even eligible for guaranteed unpaid leave. The most important federal workplace leave law is the Family and Medical Leave Act (FMLA), a 1993 law that guarantees covered workers the right to job-protected leave for their own or a family member’s serious health needs or to bond with a new child.¹⁴ Since its passage, FMLA leave has been used nearly a half-billion times,¹⁵ offering invaluable protections to workers and their families.

Yet the FMLA contains two important limitations. First, due to restrictive eligibility criteria, nearly half of all employees in the United States, 44 percent, are not covered by the law, including 46 percent of women employees.¹⁶ Second, even for those who are covered, FMLA leave may be unpaid, putting leave out of reach for those who cannot afford to go without a paycheck.¹⁷

Without access to paid family and medical leave, workers and their families suffer. As prior Center for American Progress research found, American women need a total of 5.9 million leaves they do not take each year.¹⁸ Among workers who needed but did not take leave, the inability to afford leave is by far the most common reason, followed by fear of losing their jobs and workplace discrimination.¹⁹ In addition, women take 3.8 million leaves per year unpaid.²⁰ These gaps in income have major economic security implications, as workers borrow money, use savings intended for other purposes, put off paying bills, or go on public assistance.²¹

The consequences of the lack of national paid leave fall particularly hard on families of color. Among Black women, more than 60 percent of needed leaves are either taken without pay or not taken at all.²² Nationwide, Black women lose an estimated $3.9 billion in wages each year while on leave.²³ Because women of color, particularly Black women, are disproportionately likely to be the sole or co-breadwinners in their families,²⁴ they are much less likely to be able to absorb even a temporary stoppage in their earnings without significant hardship. Moreover, lack of access to paid family and medical leave exacerbates and is compounded by enduring racial wealth gaps.²⁵

The economic benefits

The failure to guarantee paid leave across the United States is not only harming workers—particularly women and their families—but also dragging down the U.S. economy. Each year, according to Center for American Progress research, the economy loses more than $22.5 billion in lost wages alone due to lack of paid family and medical leave, with more than half of that amount—nearly $12 billion—attributed to women’s lost wages.³⁰ Paid leave is an investment in the U.S. workforce, enabling workers to take the time they need and return focused and ready, rather than being pushed out of the workforce or forced to compromise their own health or the health and care of their loved ones.

Paid leave is a proven tool for increasing labor force participation, especially for women.³¹ When states adopt paid leave programs, mothers are more likely to work and to work more hours following a child’s birth than without such programs.³² Moreover, these impacts last over time, as mothers with access to paid leave at the time of birth are more likely to stay in the workforce. Paid leave has been shown to increase mothers’ labor force participation even years after giving birth.³³

Nor are the labor force attachment impacts of paid leave limited to mothers. Women continue to bear a disproportionate share of caregiving responsibilities; 61 percent of unpaid caregivers for loved ones are women.³⁴ Center for American Progress research found that California’s paid family leave law increased labor force participation for family caregivers by 8 percent in the short term and 14 percent in the long term.³⁵

Scaled nationally, that increase would correspond to more than 6 million additional caregivers, including 3.7 million women, in the labor force.³⁶ Similarly, after paid family leave policies were implemented in New Jersey and California, the likelihood that older women with spouses or nearby parents in poor health were working while providing care increased as compared with those in states without paid leave.³⁷

Paid leave also helps those working through their own serious illnesses, such as cancer, to keep their jobs.³⁸ Today, significant changes in workers’ health or their health’s impact on their ability to work are the biggest drivers of unplanned early retirement.³⁹ Paid leave can help mitigate those effects by providing workers with greater tools to balance work and health, helping them to stay in the workforce rather than be pushed out.⁴⁰

The policy recommendations

Policymakers must step up to guarantee comprehensive, inclusive paid family and medical leave for all workers. The beneficial consequences for women and the broader U.S. economy are clear. Some states are leading the way, but more can be done in other states and at the federal level.

Federal policy recommendations

• Congress should pass the FAMILY Act:⁴¹ This proposed law would guarantee workers across the country the right to up to 12 weeks of paid, job-protected leave to bond with a new child, address their own serious health needs, care for a seriously ill loved one, respond to sexual or domestic violence, or deal with the impact of military deployment.
• To complement these protections, Congress also should pass the Healthy Families Act: This proposed legislation would provide seven days of paid sick and safe leave.⁴²

State policy recommendations

• Thirteen states and Washington, D.C., have already passed their own comprehensive paid family and medical leave laws:⁴³ Additional states should follow their lead and guarantee these essential protections to their workforce.
• State policymakers should complement paid family and medical leave protections by guaranteeing paid sick and safe time for all workers.⁴⁴

Conclusion

Guaranteed paid family and medical leave is a powerful investment in a thriving workforce, healthier families, and a more robust economy. While all workers need paid leave, women are bearing the brunt of the adverse consequences of the absence of such policies and will reap much of the benefit from paid leave, pulling up the U.S. economy with them.

The author would like to thank Rose Khattar, Sara Estep, Lily Roberts, and Kyle Ross for their helpful feedback and assistance.