The Role of Paid Leave During COVID-19: What Has Been the Impact and How Do We Move Forward?

State Health Policy Leadership Population Health COVID-19

During the spring of 2020, Americans were urged to work from home, wear masks, practice social distancing, and take other precautions against the spread of COVID-19. The Centers for Disease Control and Prevention (CDC) recommended that Americans who couldn’t work remotely stay home if they or someone in their household became ill. Yet, many workers couldn’t adhere to CDC recommendations because they did not have access to paid sick leave and taking unpaid sick leave was not financially viable. In March 2020, we wrote about the pressing need to pass emergency paid sick leave legislation and the need for permanent solutions to address the inequitable access to paid sick leave in the United States. When employees have access to paid sick leave they are more likely to seek preventative care and are able to stay home and recover if they or their children fall ill, instead of delaying care or exposing their workplace to infectious disease. In this piece, we build on that blog to discuss the federal policies that have been enacted and implemented over the past year — and how these policies may have helped curb the spread of COVID-19, underscoring the need for a permanent national paid leave solution.

How the Federal Government Responded

In response to the health and economic impact of the COVID-19 pandemic, Congress passed the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Response, and Economic Security (CARES) Act in March 2020. One provision of these massive legislative packages provided new rights to some workers in the form of short-term emergency paid sick and family leave for coronavirus-related health and caregiving emergencies. The FFCRA required employers with fewer than 500 employees to offer two weeks — up to 80 hours — of job-protected paid sick days and 10 weeks of paid expanded family and medical leave for eligible workers to care for their children during school closures. The law also included tax credits to reimburse employers and self-employed workers for the cost of providing emergency paid sick leave and paid family leave.

Access to Paid Leave and its Impact

The federal legislation ensured that approximately 65 million private-sector workers and 22 million public-sector workers could access paid sick leave should they or a loved one fall ill or need to self-isolate or quarantine. While these legislative efforts were a historic step forward to protect workers during this unprecedented public health crisis, exemptions excluded at least 59 million workers of businesses with 500 or more employees and 16.6 million health care and emergency response workers. And an estimated 34 million employees of small businesses with 50 or fewer workers were not guaranteed access to emergency paid sick and paid family leave benefits when caring for a child whose school was closed or whose childcare provider was unavailable.

The exemptions in the legislation primarily applied to low-wage workers, who are predominantly women, people of color, and immigrants. While some large businesses may offer paid leave benefits, they are often not provided equitably, leaving low-wage workers least likely to access paid leave when needed. Bureau of Labor Statistics data show that workers in public-facing occupations, like service workers, are less likely to have paid sick days compared to those in professional jobs. For eligible workers, the use of emergency paid family leave was also limited to caring for a child whose school or childcare provider was closed due to COVID-19. This narrow scope meant workers were unable to use this leave for long-term medical leave or other caregiving needs, such as helping a parent or spouse affected by COVID-19.

Despite these limitations, there is one study suggesting access to emergency paid sick leave may have helped curb COVID-19 transmission in the United States. Researchers estimate that in states where workers gained access to emergency paid sick leave under the FFCRA there were approximately 400 fewer confirmed cases of COVID-19 per state per day than would have occurred without the FFCRA requirements. Previous research demonstrates that access to paid sick leave can decrease the spread of infectious diseases, like the flu, in the workplace because less people attend work while sick.

Paid Leave Beyond COVID-19

On December 21, 2020, Congress passed a $2.3 trillion legislative package containing both appropriations for Fiscal Year (FY) 2021 and additional COVID-19 relief. As part of this bill, the tax credits to cover the cost of providing emergency paid sick and family leave to reimburse employers and self-employed workers were extended through March 31, 2021. However, the mandate that employers provide emergency paid sick leave to eligible employees was removed, making emergency paid sick leave voluntary. While the impact of this policy change has yet to be seen, it is anticipated that weakening these worker protections will result in fewer employees being granted emergency paid sick leave at a time when it is most needed.

Enacting federal emergency paid sick and family leave at the start of the COVID-19 emergency was a step forward, but Americans still need a permanent paid leave solution. As we continue to address the current health and economic impacts of COVID-19, the Biden administration and 117th Congress should take action to support employee access to federal emergency paid leave and expand access to workers that were originally left out of the FFCRA. Doing so would allow more employees to take paid leave to self-isolate or quarantine when necessary and decrease COVID-19 transmission. Building upon these actions, enacting federal legislation for permanent paid leave would strengthen the nation’s ability to proactively respond to infectious disease outbreaks and protect workers from experiencing economic hardship after the COVID-19 crisis. In absence of federal action, states and localities should enact their own paid sick leave policies to provide important protections that will help safeguard the health of individuals and communities across the country.

Currently, 15 states and the District of Columbia have a paid sick leave law in place. Across states, eligibility requirements, employer size, how and when an employee may use their time, and rate of leave accrual of the laws vary. New York has enacted one of the most generous paid leave policies in response to COVID-19. The law requires employers with five or more employees – or net income of more than $1 million — to provide at least five days of job-protected paid sick leave for quarantine or isolation orders. Large employers must provide 14 days of job-protected paid sick leave. Employers with fewer than five employees and a net income of $1 million or less must provide up to five days of unpaid sick leave. The law applies to all private sector employees with no exemptions and eligible workers may accrue one hour of paid leave for every 30 hours worked. The robust law is one example of how state paid sick leave policies can protect workers now against COVID-19 and other infectious diseases after the pandemic.