: A growing number of states require employers to offer paid sick leave — now for the bad news

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While a growing number of states now require employers to provide paid sick leave, even more states without paid sick-leave laws have passed laws barring local governments from enacting their own such requirements, a new study says.

The net result is widespread inequity that falls heavily on lower-wage workers, whose employers often don’t provide sick-leave benefits, lead study author Jennifer Pomeranz, an assistant professor of public health policy and management at the NYU School of Global Public Health, told MarketWatch.

The study, published in the American Journal of Preventive Medicine, found two large and opposite shifts between 2009 and 2020: The number of states withdrawing the authority of local governments to pass sick-leave regulations — an increasingly common occurrence called preemption, where a higher level of government overrules the authority of a lower level — ticked up from one state to 18. 

This trend is part of a “culture of state preemption” over the past decade across subject areas, Pomeranz said, as well as a response to local governments passing laws that state governments don’t like.

Meanwhile, the number of states passing laws during that period requiring employers to provide paid sick leave increased from zero to 12. (Paid sick-leave laws in Maine and Colorado only went into effect in 2021, and were therefore not included in the study. The study also didn’t assess private companies’ paid sick-leave coverage.)

“This creates inequity both within and across states, because only certain employers are required to offer paid leave,” Pomeranz said. “The lowest-wage workers often are not given paid sick leave, so when employees are at the behest of the employer, we know the lowest-wage workers suffer.”

Paid sick leave was available to 77% of the private workforce in March 2021, according to the most recent Bureau of Labor Statistics data available, but only 59% of workers in service occupations and 33% of the lowest-earning 10% of workers had access.

Many workers earning low wages without paid sick leave have had to choose between showing up to work sick and forgoing a paycheck during the pandemic. Working while sick, in turn, can spread the virus to coworkers and their loved ones.

“Especially in the U.S., working while sick was kind of a given prior to COVID — the idea that ‘Of course you come in if you only have a cold or the flu,’” Pomeranz said. “I’m hoping [this study] brings to light the broader ramifications of the need for paid sick leave, with or without COVID.”

He added, “Staying home while sick is imperative to your community and also your own wellbeing.”

COVID-19 has also taken an uneven toll on workers across the income spectrum, as low-income workers have faced higher risk of exposure and barriers to getting vaccinated.

For the two weeks ending Jan. 10, working-age Americans making less than $25,000 a year were 3.5 times as likely to say they’d missed a whole week of work primarily because they got sick with COVID-19 or had to care for someone else with symptoms, according to an analysis published by the left-leaning Economic Policy Institute.

‘Variation in state paid sick-leave laws, preemption, and lack of employer provision of paid sick leave to low-wage workers creates substantial inequities nationally.’


— study published in the American Journal of Preventive Medicine

Essentially, Pomeranz and her coauthors found that in 18 states during the study period, there could be no requirement for employers to provide paid sick leave. In states with no state laws around paid sick leave, local governments can (and have) enacted laws requiring paid sick leave, Pomeranz added — but there are still inequities across the state, because some locations require it and others don’t. 

And in states that do require either public or private employers to provide paid sick leave, there’s still variation based on whether both public and private employers are covered, or there are exclusions based on employer size or certain vocations, Pomeranz said.

The U.S. is among few wealthy nations that doesn’t require employers to offer paid sick leave. A temporary paid sick-leave mandate in the 2020 Families First Coronavirus Response Act applied to public employers and employers of fewer than 500 people, but expired at the close of that year. 

Related: Paid family leave in New York ‘does not seem to hurt employers,’ a new study finds

Meanwhile, the pandemic did prompt some employers to begin offering or expand access to paid sick leave for their workers. Paid sick-leave policies have also picked up steam at the state and local level, according to the healthcare think tank KFF

The authors of the NYU study, for their part, called for paid sick-leave requirements at the federal level.

“Variation in state paid sick-leave laws, preemption, and lack of employer provision of paid sick leave to low-wage workers creates substantial inequities nationally,” they wrote. “The federal government should enact a national paid sick-leave law.”