In summary

With paid family leave on the agenda in D.C., we have an opportunity to ensure California’s experience informs a better federal policy.

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By Debbie I. Chang

Debbie I. Chang is president and CEO of Blue Shield of California Foundation.

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Jenya Cassidy, Special to CalMatters

Jenya Cassidy is director of California Work & Family Coalition.

California has led a movement among states to establish and improve paid family leave and job protections for all workers, but we must do more to eliminate the inequities built into leave policies. 

With paid leave on the agenda in Washington, we have an opportunity to ensure California’s experience informs an even stronger federal policy that is inclusive of all workers.

The problems with current policies are in who is left out.

Employees of small companies, part-time workers and recent hires get limited, if any, benefits due to exemptions and basic eligibility requirements in the federal Family Medical Leave Act, which provides unpaid leave in some circumstances. Gender and race are not specifically addressed in the act, but a recent analysis from UCLA shows that exemptions apply disproportionately to women and people of color.

Workers who are eligible and have access to paid leave based on state laws face other barriers. For example, a young father who wants to take paid paternity leave to be with his newborn knows that his family cannot get by for even a short time at the wage-replacement rate. A wage replacement of 60%, the current rate in California for most workers who qualify, is much different for a low-wage worker, who depends on their entire salary for daily living expenses, than for someone with a higher income.

Unequal access to paid time off compounds the hardships in low-income communities and widens racial and gender disparities.

A look around the world shows that paid leave for all workers is possible. 

UCLA’s review found that 181 countries have paid medical leave laws without broadly exempting small businesses. More than two-thirds of high-income countries with paid or unpaid medical leave include self-employed workers, and 93% cover part-time workers with no minimum tenure before coverage begins. The U.S. currently has no national paid leave policy, and unpaid leave under the Family Medical Leave Act is full of exemptions.

When anyone lacks paid leave, everyone is affected. 

For 4.6 million care workers in the U.S. who help with children, elders and individuals with disabilities, the ramifications of inadequate paid leave reach far beyond their households, impacting countless people who rely on them for care and their families. Strong paid leave policies offer workers the security and flexibility they need to remain in the workforce while also caring for their own families.

Generous paid leave has broader benefits to health as well. It allows time for self-care, increases family caregiving and leads to higher rates of breastfeeding along with improved maternal and child health. Paid leave also reduces financial stress, a risk factor for many health issues, including domestic violence. And paid leave improves access to preventive care, which often is unavailable outside working hours.

A wealthy state and nation like ours should provide paid leave for everyone, eliminating disparities across race, ethnicity, gender and socioeconomic status. Building on California’s success, a new national medical leave policy must include an adequate wage replacement rate of at least 90% to 100% for the lowest-paid workers; provide at least 12 weeks off for major illness, bonding with a new child and other needs; and explicitly guarantee cover­age regardless of employer size, tenure, hours or occupation type.

Providing widespread, equitable access to paid leave will benefit our whole society and improve health and health equity in California and across the nation.


Debbie I. Chang has also written about how to leverage federal dollars to advance equity through community councils.

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