When the Minnesota legislature was debating a paid sick leave bill last year, business owners argued that such a law would not allow them to provide as many employee “perks” or be as “adaptive” to employee needs as they say they would be without such a requirement.? But a half dozen witnesses made a case for the need, with many workers sharing examples of the numerous times they had to work while ill.

Maria Vazquez, a member of a worker organizing group in Minneapolis, told lawmakers she frequently felt too sick to work her job as a housekeeper but couldn’t afford to not show up.

“And so there have been many times I have presented to work, not only with a high fever but to the point where my legs could barely support me and people would ask me why are you working and there wasn’t really a choice without the sick and safe time,” Vazquez said.

The earned sick and safe time bill ultimately passed and the law went into effect this month. Another bill providing paid family and medical leave also passed last year but takes effect in January 2026. Minnesota joins 14 other states and the District of Columbia that now require paid sick days. Meanwhile 13 states and DC provide paid family leave and medical leave, which provides for longer time off, according to KFF. Washington, which has had a paid sick leave law since 2018, has updated its law to cover accrual of sick time for construction workers, to take into account that these employees may have multiple employers in a short period of time. Those changes took effect Jan. 1. California workers recently won an increase in the number of paid sick days employers must provide, from three days to five days. In July, Chicagoans will be able to get five sick days each year.

And while there are still plenty of states like Kentucky that offer no paid time off — either for sick days or family and medical needs — the political momentum for paid sick leave is continuing in other states this year. Policy experts say that momentum may eventually force the federal government to pass federal legislation as more people recognize the economic value of paid sick leave.

Advocates for paid sick time in Alaska, Nebraska and Missouri are pushing ballot initiatives this year. The group Paid Sick Leave for Nebraskans wants to see full-time workers enjoy a minimum of five to seven days of paid sick time and for other employees to receive some paid sick time as well. Missourians for Healthy Families and Fair Wages has launched a campaign to get paid sick time and an increase in the minimum wage on the ballot this year in their state. The amount of paid sick time for employees would correspond to their hours and employer size.

Policy advocates and economists say a lack of paid sick leave, which tends to impact the most economically unstable workers, forces workers to choose between financial stability and their own wellness as well as the health of their family and coworkers.

The issue is particularly pressing this month as respiratory viruses are surging. According to the Centers for Disease Control’s Jan. 5 update on respiratory virus activity, which includes the flu, RSV, and COVID-19, shows that visits to the emergency department are “elevated in all age groups” and rising, with the exception of school-aged children. Wastewater levels indicating infections are 27% higher. Hospitals are reporting a rise in COVID-19, flu, and RSV cases, including in Michigan, Ohio, Maryland, and New Jersey.

COVID-19 driving discussions

Molly Weston Williamson, senior fellow at the Women’s Initiative at the Center for American Progress, said the COVID-19 pandemic played a part in driving the policy discussion about paid sick time.

“The pandemic placed a new level of attention on the need for paid sick leave, driving home the critical public health stakes as well as the economic and human costs of the status quo — a need only underscored by union action like the rail workers’ fight for paid sick leave,” she said. “That led to increased policy attention, from temporary COVID paid leave at the federal level in 2020 to new and expanded state and local protections.”

To improve these working conditions, some Democrats and labor advocates are advocating for the passage of legislation such as the federal Healthy Families Act, which would provide a national right to earn time off that is job protected and provides a way to calculate the accrual paid sick time, and the FAMILY Act, which provides paid family and medical leave benefits. (The Family Medical Leave Act, or FMLA, which was passed by Congress in 1993 over opposition from the business community, requires employers of a certain size to only offer unpaid family leave.)

A House bipartisan family leave working group has released a framework for legislative options for paid leave, such as public-private partnerships for state-run programs and paid family and medical leave tax credits. A federally funded program for paid leave was not included in those options.

In the past, Republicans on the federal level have disagreed with Democrats over how broadly to provide family and medical leave and how to fund that leave.

Sherry Leiwant, co-president and co-founder of A Better Balance, said that the released framework is a good step toward advancing more worker-friendly policies in Congress.

“Maybe the Republicans are coming around to recognizing that this is really important to people.”

And with more states passing laws on paid sick time, Leiwant said businesses may be realizing that they need more consistency, especially if they operate across state lines.

An economic necessity

The need for paid sick days to help stabilize workers’ finances is clear through the data, according to an Economic Policy Institute report released in November. Compared to 63% of private sector workers having access to paid sick days in 2010, 78% now do and during the same period, the percentage of the lowest wage workers who had paid sick days almost doubled, the think tank found. The report’s authors also calculated what workers would be giving up in housing, groceries, transportation, and other essentials for their unpaid sick days.

“If we think about taking off work without any assets or savings, that could have a very big impact on the family budget,” said Hilary Wething, an economist at the Economic Policy Institute, and one of the report’s authors. “If a worker loses wages for taking off five days for example, if they have RSV or their kid has RSV that could be their entire grocery budget for the month. If they take three days off, it could be the entire monthly budget of utilities and two days could be a monthly budget of gas, which could make it difficult to get to work. You can see how a series of events could cascade for them and become a much bigger problem than it had to be.”

State Republican lawmakers and business groups have often argued that paid family leave and paid sick time is a burden on businesses and may reduce workers’ benefits. But Wething said such arguments against paid sick time are not supported by the available research and that the stability in both the health and finances of workers could also benefit employers.

“If we have a healthier workforce, we have a more productive workforce and we have to remember that every sick worker can reduce businesses’ productivity,” she said. “I think a federal mandate allowing more people the opportunity to earn paid sick leave, essentially by having fewer people show up to work sick, will have an effect on the economy writ large from a public health perspective that’s going to be great for employers’ bottom lines.”

Williamson of the Center for American Progress, said it’s about time that the federal government learned from the effects of the COVID-19 pandemic and passed the Healthy Families Act.

“We know that paid sick leave works — for workers, for businesses, and for the health of our communities,” she said. “And yet, as we approach four years since a deadly pandemic hit our shores, at the federal level, the United States still does not guarantee a single day of paid sick time.”