Paid Family and Medical Leave

A man holds his newborn infant in a hospital waiting room.

Proponents of mandatory paid family and medical leave argue that it’s long past time that the United States got in step with other wealthy nations.


What's the issue?

Most people at some point in their lives need to take time away from work to deal with a serious personal or family illness or to care for a new child. In contrast to almost every other developed nation in the world, the United States has no federal law that guarantees paid family or medical leave, whether that leave is to care for a new child or a seriously ill family member, or to address one's own serious health condition. Indeed, the United States is one of only two wealthy, industrialized countries (along with South Korea) that does not guarantee paid medical leave for serious illness.

The United States does have a law—the Family and Medical Leave Act (FMLA) of 1993—that requires some businesses to offer unpaid leave to some workers for serious medical and family care needs.

Proponents of mandatory paid family and medical leave argue that it's long past time that the United States got in step with other wealthy nations. They point to the hidden costs of the status quo and a growing body of evidence that shows that paid leave improves family financial stability and public health, and that it's a plus for businesses as well as workers. Opponents assert that mandatory paid family and medical leave places a significant burden on businesses and should be a benefit they choose to offer, or not. They point to the many large and midsize employers that offer paid leave to full-time employees as examples of this alternative system. In addition, they argue, it's a policy issue best left to states.

Four states have enacted paid medical and family leave laws—California, New Jersey, New York, and Rhode Island. And paid family leave laws were proposed in twenty states plus the District of Columbia in 2016.

This debate has been under way for many years but has become reenergized during the past year by a recently proposed national law—the Family and Medical Insurance Leave (FAMILY) Act--as well as state policy victories, substantial public activism, and the presidential campaign. Even some conservative groups, once reluctant to endorse policy solutions that involve public investments, have proposed access to paid leave.

The politics of guaranteed paid leave remain uncertain, however. President-elect Donald Trump during the campaign surprised many in the Republican Party by proposing a modest paid maternity leave policy. Republicans in Congress might oppose guaranteed paid leave in any form or promote their own reform. For example, some lawmakers have proposed voluntary programs aimed at incentivizing businesses to offer paid leave and workers to save for their own medical and family absences.

What's next?

Proponents of paid leave are expected to significantly ramp up their efforts in 2017 in both the states and the District of Columbia. In then-candidate Donald Trump's proposed paid maternity leave plan, some proponents might find reason to be hopeful about the potential for future bipartisan collaboration on the issue. But with Republicans controlling both houses of Congress, movement on legislation as progressive as the FAMILY Act is unlikely in 2017. The difficulty inherent in creating a new entitlement program for US workers cannot be overstated. Much depends—as with other issues--on whether a moderation in the hyper-partisan and combative political environment takes place.

Other social and political issues could also give impetus to paid leave. In particular, public debate over wage stagnation, pay inequality between men and women, and the widening gap in income and assets (including retirement savings) between low-wage and middle-income families and upper-middle-class and wealthy families are likely to include prominent mention of the paid leave gap between rich and poor. These debates could create pressure to pass laws that help lower- and middle-income families beyond policies such as raising the minimum wage.

Media Contacts

Melissa Blair

Robert Wood Johnson Foundation (609) 627-5937

Additional Media Contact: Sue Ducat

Health Affairs (301) 841-9962

Related Content

Paid Family Leave Policies and Population Health

Evidence suggests that the introduction of paid family leave for up to one year may yield child and maternal health benefits in the short and long run.

Learn more