Paid Family and Sick Leave in the U.S.


Workplace benefits are an important part of balancing work, family, and medical needs. Benefits such as paid family and medical leave and sick leave can help employees meet their personal and family health care needs, while also fulfilling work responsibilities. Yet, many U.S. employers do not offer paid leave time to their workers.

The federal Family and Medical Leave Act (FMLA) requires eligible employers to provide unpaid family leave. However, unlike nearly all other industrialized nations, the U.S. does not have national standards on paid family or sick leave, despite strong public support. Paid leave has garnered attention among the 2020 Democratic presidential candidates, with most expressing support for a national policy, and President Trump has allocated funds for paid family leave in his budget, though the administration has not issued a formal proposal yet. Some efforts at the federal level have begun to gain momentum, including the Healthy Families Act, introduced in the House of Representatives and in the Senate in 2019, which would require most employers to offer workers paid sick leave. The Federal Employee Paid Leave Act took effect in October 2020 and grants federal employees 12 weeks of paid parental leave following the birth or placement of a child.

There have been a number of local and state initiatives to expand access to paid leave in parts of the U.S. Employees not covered by these local laws must rely on voluntary employer policies, which can vary considerably. This is a particularly salient concern for women, who are often the primary caretakers for children and aging parents and also comprise nearly half of the nation’s workforce.

This fact sheet summarizes state and local policies on paid family medical leave and paid and sick leave and presents data from the KFF Employer Health Benefits Surveys on the share of firms that offer workers these benefits.

Federal, State, and Local Policies on Family and Sick Leave

FMLA and Unpaid Family and Medical Leave

The most recent nationwide policy reform occurred in 1993, when the federal government passed the FMLA, giving eligible employees up to 12 weeks of unpaid leave to care for seriously ill family members, the arrival of a child, and job protection when an employee returns from family or medical leave. The law applies to public agencies and private employers with 50 or more employees. The FMLA has provided job security to millions of workers who take time off to care for a critically ill family member or a new child in the family. However, only 60% of the workforce is eligible for FMLA protections because small employers are exempt, and even in covered worksites, not all employees are eligible. Since 1993, 15 states and the District of Columbia have expanded unpaid leave benefits beyond FMLA standards by either increasing the amount of leave time offered or expanding the definition of an eligible family member.

Paid Family and Medical Leave

On the paid leave front, there have been many attempts to build upon the FMLA and enact a national paid leave policy, but no federal legislation has ever been passed. President Donald Trump’s budget for fiscal year 2020 included a proposal for paid parental leave for all U.S. workers after the birth or placement of a child. The budget allocated $20 billion over the next 10 years to fund the program, but a formal proposal has not been issued by the administration. The Family and Medical Insurance Leave (FAMILY) Act, introduced in 2019 in the House of Representatives and in the Senate, if passed, would create a national insurance program to provide workers up to 12 weeks of their partial income for their own serious health condition or that of an immediate family member, and for the birth or placement of a child. The program would be funded by employee and employer payroll contributions.

Proponents of a national paid family and medical leave urge that it would provide employees with greater financial security when they must take an extended leave for medical reasons or to care for an ailing family member or new child. Opponents cite concerns about the impact of new federal requirements on local government and employers as well as the financial implications a new benefit would have on wages and employment.

There has been some progress on paid family leave for federal workers. The Federal Employee Paid Leave Act, which took effect in October 2020, grants federal employees 12 weeks of paid parental leave following the birth or placement of a child. The policy, part of the National Defense Authorization Act for Fiscal Year 2020, will apply to 2.1 million civilian workers employed by the federal government, though employees must have been in federal service for at least a year to be eligible.

Nine states and D.C. have enacted paid family and medical leave laws in their jurisdictions (Figure 1), an increase from four states in 2016. In November 2020, Colorado became the first state to enact paid family and medical leave through a ballot measure. These states administer and fund paid leave through employer and/or employee payroll contributions to allow workers to care for a seriously ill family member or to bond with a new child, and typically provide partial wage replacement up to a designated cap.

Figure 1: State Paid Family and Medical Leave Laws, 2020​

Paid Sick Leave

There is no federal requirement that employers offer employees paid sick leave when they or a family member has a short-term illness that does not permit them to work. In 2015, the Obama Administration issued an executive order that requires federal contractors to offer at least seven days of paid sick leave per year to their employees, on an accrual basis, which took effect in 2017. At the time of enactment, this applied to approximately 300,000 people working on federal contracts. Furthermore, government employees have generally had access to paid sick leave through employee benefits packages. Introduced in Congress in 2019, the Healthy Families Act would require employers nationwide with 15 or more employees to provide at least one hour of earned paid sick leave for every 30 hours workers (up to a maximum of 56 hours per year). Employees would be able to use sick leave for their own illness, to care for a family member, or to address needs resulting from domestic violence, sexual assault, or stalking.

There has been more traction on paid sick leave policies at the state and local level (Figure 2). Since the first law was passed by voter initiative in 2006 in San Francisco, 12 states, plus D.C.1, and 21 other localities have passed laws requiring that eligible employees get paid time off to care for themselves or sick children.2 Two additional states (ME and NV) have general paid leave laws that allow employees to use accrued leave for any reason, including illness. Eight states’ and eleven localities’ requirements explicitly apply to public health emergencies, such as closure of a business or child’s school to protect public health. All state and all local paid sick leave laws permit use of accrued leave for reasons associated with sexual assault, domestic violence, and stalking, except Pittsburgh’s. Current paid sick leave laws generally work on an accrual basis, dependent on previous hours worked. The pay rate and the amount of paid sick time that can be accrued varies by policy.

Figure 2: State and Local Paid Sick Leave Laws, 2020

Employer Health Benefits Data

Paid Parental Leave

The 2019 KFF Employer Health Benefits Survey asked a nationally representative sample of non-federal public and private employers about the benefits they offer their employees. Overall, 25% of firms offer paid parental leave (either maternity, paternity, or both) to at least some employees for the birth or placement of a child. Thirty-five percent of workers are employed in firms that offer paid parental leave.

Paid parental leave offer rates vary by firm characteristics such as size and wage levels. Firms with 1,000 or more workers (35%) are more likely to offer paid parental leave than smaller firms (Figure 3). Among large firms (200 or more workers), firms with many higher-wage workers3 (41%) are more likely to offer paid parental leave than firms with few higher-wage workers (23%) (Figure 4).

Figure 3: Percentage of Firms That Provide Paid Parental Leave, by Firm Size, 2019​

Figure 4: Percentage of Large Firms That Provide Paid Parental Leave, by Firm Characteristics, 2019​

Paid Sick Leave

The 2017 Employer Health Benefits Survey found that about two in three firms (68%) provide paid sick leave to their full-time workers (Figure 5). Large firms (94%) were more likely than small firms (3-199 workers) (67%) to provide paid sick leave to their full-time workers. While only a small fraction (1.7%) of firms in the U.S. are classified as large, they employ approximately 62% of the nation’s workforce. Between 2016 and 2017, the share of large firms offering paid sick leave to its full-time workers increased from 84% to 94%.

Figure 5: Percentage of Firms That Provide Paid Sick Leave to ​Full-Time and Part-Time Workers, by Firm Size, 2017​

Paid leave benefits are far less prevalent for part-time workers, and are more commonly offered by large firms. Over half of large firms (56%) provided paid sick leave to their part-time workers, compared to about a quarter (26%) of small firms. There is variation between different sizes of small and large firms in the provision of paid sick leave, for both full- and part-time workers.

Whether or not a firm offers paid sick leave also depends on firm characteristics. Among large firms, private for-profit firms (88%) are less likely to offer this benefit than private not-for-profit (99%) and public employers (100%) (Figure 6). Additionally, large firms with at least some union workers (98%) are more likely than firms with no union workers (92%) to provide paid sick leave to their full-time staff.

Figure 6: Percentage of Large Firms That Provide Paid Sick Leave to Full-Time Workers, by Firm Characteristics, 2017​

Among non-federal employees, 87% work in firms that offer paid sick leave to their full-time workers and 50% work in firms that offer this benefit to part-time workers. The lower likelihood of paid sick leave for part-time workers has a disproportionate impact on women, who are more likely than men to hold part time jobs. Women are also more likely than men to care for children when they are sick and have to stay home from school.


Paid leave continues to be a significant national and local policy issue and has garnered the attention of many 2020 Democratic presidential candidates. President Trump has spoken about the need for supporting working class Americans, and forwarded the framework for a proposal to offer paid parental leave to all workers in the U.S. At this point, the proposal lacks details and it remains to be seen whether Congress will take up this issue, though some lawmakers have introduced legislation. However, a new policy that took effect in October 2020 provides federal employees 12 weeks of paid parental leave following the birth or placement of a child. Short of that, the movement for paid parental and sick leave will likely continue to be centered on state and local policies or those voluntarily adopted by employers or negotiated through union contracts. Given that most people will need time off during their working lives to care for a personal or family illness, or for a new child, this issue will continue to be a salient concern for working families across the country in the years to come.

  1. Nearly two-thirds (8) of the thirteen state laws (including DC) were enacted just in the past four years. Five were passed between 2008 and 2015.

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  2. Bernalillo Co., NM, has a paid sick leave law that is not included here because it only applies to employers in unincorporated parts of the county; most employers are located in Albuquerque.

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  3. Firms with many higher-wage workers are those where at least 35% of workers earn more than the 75th percentile of national earnings ($63,000 in 2019).

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