Throughout the pandemic, millions of Americans have had to wrestle with the decision to work when they or a loved one is suffering from Covid-19. The US, unlike all other developed countries, does not have any federal permanent requirements for paid leave, which includes medical and family leave.
That could change if Democratic presidential nominee Joe Biden wins the US election on Nov. 3. His plan to fight the coronavirus pandemic includes paid leave for those exposed or sick with Covid-19, or those who need to quarantine. Some experts say it’s the only way to stop the virus’s spread in the US—and could benefit workers even after the virus is under control.
Historically, a lack of mandated paid sick leave has left some 20 million Americans to choose between their income and their health; predictably, it’s people in low-paying jobs or those relying on gig work—a group disproportionately made up of women and people of color—who suffer the most.
It’s not at all strange that a social or economic policy would be considered an essential part of a public health strategy.
During a pandemic, the effects are even more acute. A person who becomes a sole breadwinner can’t afford to stay home if a family member becomes sick, or if health complications make them more susceptible to Covid-19. A parent without paid leave has to scramble for childcare if schools are closed. And the impacts can extend to the community: A person who has symptoms of Covid-19 and can’t sacrifice income may go to work and spread the virus to others.
In the short term, it’s pretty clear that having a paid leave policy reduces the spread of coronavirus. “In order to mitigate spread, you want to stay home, and that might mean not going into your workplace for longer than just a few days,” says Maya Rossin-Slater, an assistant professor of health policy at Stanford University. “Having a temporary medical leave policy would absolutely enable people to make use of that in order to stay home.”
Emergency leave vs. lasting change
The first coronavirus stimulus bill, signed into law on Mar. 18, helps some people. Through the end of 2020, workers who are being tested or treated for Covid-19 symptoms can get up to two weeks of sick leave if they’re not already covered; the federal government will reimburse employers up to $511 per day to pay those wages. And those with family members affected by the virus, or with kids who stay home because of school closures, could make up to two thirds of their pay, capped at $200 per day for 10 weeks.
But some proponents of paid leave say the law doesn’t do enough to protect workers since it excludes companies with more than 500 employees and allows those with fewer than 50 people to opt out.
Biden’s plan as laid out on his campaign website works differently. Workers in a range of situations caused by Covid-19 could be paid directly by the federal government or through their employers. And it would cover 100% of weekly salaries, capped at $1,400 a week, for up to 14 days.
The specifics of the Biden’s policy—paying a higher proportion of weekly salaries, for example—make it more progressive than existing leave policies in states like California, Rossin-Slater says.
“My sense is that this kind of policy would tremendously reduce the current disparities between low- and high-wage workers,” says Rossin-Slater. Already, the pandemic has created health disparities, she says: Higher-wage workers can do their jobs remotely, while lower-wage workers in places like restaurants and grocery stores have to show up in person, increasing their exposure to the virus. “By making this a federal policy, they’re going to close that gap,” she says.
It’s a very obvious policy solution to a glaring policy problem that long predates Covid.
The plan could also help keep women in the workforce, critical at a time when they are dropping out at unprecedented rates. “It’s untenable to have a full time job and full time caring for one’s child. Having some kind of paid leave policy would potentially provide a buffer,” Rossin-Slater says.
In the past, there has been a lot of pushback around these kinds of policies, Rossin-Slater says, because of fears that they would prove too costly for small businesses. In surveys to employers in states with such policies already in place, though, this has proven to be unfounded. A 2010 survey by Harvard Business Review found “that the program has been a non-event for California businesses.” Another survey of New Jersey businesses (pdf) found that they “have experienced no effects on business profitability/performance and employee productivity.”
“I don’t think cost is an issue for these policies. It’s a tiny proportion of social expenditure, much less of overall of GDP. It’s something we can afford,” says Julia Lynch, a professor of political science at the University of Pennsylvania. “It’s not as if it’s some outlandish experimental thing and we don’t know if it will work. It’s a very obvious policy solution to a glaring policy problem that long predates Covid.”
Passing the bucks
Implementing such a plan would have to be done through legislation—potentially easy if Democrats sweep the presidency and both houses of Congress, but less so if not, says Paul Miller, chairman of the board of the National Institute for Lobbying and Ethics.
If Biden gets elected, it’s clear that he would want this coronavirus provision to lay the foundation for a permanent paid leave policy. His website states that “our goal must be to permanently provide” family and medical leave; it draws connections between his plan and legislation already introduced to Congress but not yet voted on, such as the Family Act and the Healthy Families Act.
“It can be very difficult to pass a policy that imposes concentrated losses on particular powerful groups. But once it’s passed and it provides benefits that improve people’s lives in meaningful ways, these laws create their own constituencies,” Lynch says—that is, once people benefit from socially progressive laws, they vote to protect them.
The need for paid medical leave might be a hard-won lesson from the pandemic. ”It’s not at all strange that a social or economic policy would be considered an essential part of a public health strategy,” says Lynch. “Access to income, healthy housing, transportation, employment, these are things that are strongly associated with good health but are also causally related.”