California was a paid leave pioneer — now it’s time for Congress to act

As a pediatrician and scientist, I have spent my academic career researching social factors affecting health and health equity for children and families, including paid family and medical leave. These paid leave programs allow someone to take time off from work to welcome a new child or deal with a serious personal or family illness, without worrying about whether they can afford to pay their bills. 

Research suggests there are short- and long-term health benefits of taking paid leave. A newborn is at decreased risk for preterm birth, low birthweight and hospitalization, and new mothers experience increased breastfeeding rates and overall improved maternal health when they have access to paid leave. These benefits rise as length of leave increases. 

When adult children have paid time off to care for their aging parents, they face less stress balancing doctors’ appointments with job responsibilities. And when some parents are faced with what may be some of the most stressful news a parent can receive — a life-threatening diagnosis for a child — paid leave allows them time to process information, make decisions, get their child out of the hospital sooner, and give comfort and care to their family. 

Our families are strongest when we all have time to recover from a serious medical condition, care for a child, or care for an ill or dying family member. Too many American families, however, are unable to take time off from work without the risk of losing their jobs. Only 19 percent of employees in the United States have access to paid family leave through an employer, and just 40 percent have access to short-term disability insurance. 

While the national Family and Medical Leave Act of 1993 (FMLA) provides some employees with the ability to take unpaid job-protected leave, approximately 40 percent of employees are ineligible due to requirements around employer size and hours worked. And even if you are eligible, you have a high chance of not being able to use FMLA anyway — 46 percent of employees who are covered by FMLA and need leave say they can’t afford to take time off without pay.

One might assume that this is just how the world works. But, it’s not. The United States is the only high-wealth country without a national paid leave policy. 

Instead of creating a national standard, our country has left it up to states to pass their own paid leave laws. To its credit, California was a pioneer, passing the nation’s first state paid leave policy in 2002 and establishing a successful model that other states have adopted and evolved. Thanks to California’s demonstration that paid leave can help employees and their families without hurting businesses, seven additional states and the District of Columbia have passed paid family and medical leave laws. But that means 42 states still have not.

California’s continued dedication to ensure access to adequate and affordable paid leave is inspiring. Advocates such as the California Work & Family Coalition and state legislators, including Rep. Lorena Gonzalez and Sen. Maria Elena Durazo, continue building momentum and writing policies to strengthen and expand our state’s paid leave program, calling for a more inclusive law that covers all employees, including recent immigrants. 

It’s time we further display California’s leadership on paid leave at the national level. The FAMILY Act is a national paid family and medical leave bill, modeled on California’s paid leave law, that is currently before the House Ways and Means Committee with support from 197 House members and 35 senators. 

Some in our congressional delegation are leading the way. The rest should seize this opportunity to highlight California’s leadership on this issue, co-sponsor the FAMILY Act, and work to ensure that everyone has the chance to take time off when necessary. Every employee should be able to follow their doctor’s orders to stay home and rest or seek treatment without risking their ability to pay bills. Our members of Congress also should advocate for amendments to the FAMILY Act that add more progressive wage replacement, a more inclusive family definition, and stronger job protection for all. 

By joining the rest of the developed world, the United States can help its residents care for their health and that of their family members without risking their income or livelihoods. Let’s not squander this chance.

Dr. Paul J. Chung is a Los Angeles-area pediatrician who is a professor and chair of health systems science at Kaiser Permanente School of Medicine. He researches medical and social influences on health, including the effects of California’s paid family leave law on children and families. The views expressed here are his alone.