Nobody should have to choose between their health and their paycheck, or between caring for their families and keeping their job. But those impossible choices remain a reality for millions of workers across the country, according to new data just released by the Bureau of Labor Statistics. Just over 25 million workers still can’t earn a single paid sick day to stay home when they’re battling the flu or take their kid to a doctor’s appointment. Eighty-five million workers don’t have paid medical leave to address their own serious health condition. This lack of supportive policies is unsustainable for working caregivers – predominantly women – particularly amid growing economic instability and the Trump administration’s open attacks on the ability of women, especially Black women, to participate fully and fairly in our economy.
Voters could not be more clear or unified in their desire to address this crisis. Public demand and mobilization have led to 18 states (including D.C.) and nearly two dozen cities and counties enacting paid sick days laws since 2006, and 14 states enacting paid family and medical leave programs since 2002. Just last November, voters in three states (Alaska, Nebraska and Missouri) overwhelmingly passed ballot initiatives for paid sick days. Yet despite seeing where voters and their communities stand, anti-worker elected officials in some states continue to stand in the way of paid leave by overturning the will of voters on Missouri paid sick days, vetoing paid family and medical leave in Virginia, and in 18 states even blocking local governments from expanding paid sick days for their communities.
Despite those political hurdles, the movement to win paid leave has continued to notch victories. This year’s data show new highs and narrowing gaps in access to paid sick days, although without comprehensive national coverage, gaps and inequities persist. Meanwhile, access to paid medical leave has stalled, declining slightly since last year. The data continue to underscore the clear need for federal action to guarantee paid leave for all workers across the country. (The Bureau of Labor Statistics did not publish updated access data for paid family leave in 2025, but this form of leave remains important and out of reach for too many workers.)
Workers Win Increases in Paid Sick Days, Setting New Records for Access
Overall, access has increased substantially since 2009, reaching 80 percent in 2025, as state and local governments have passed more paid sick days laws and unionized workers in a wide range of industries have fought for these protections in their contracts. Access has risen especially sharply to 98 percent in the Pacific region, where every state now has a paid sick days law. While access remains too low for some groups of workers, over the past decade and a half it has expanded the fastest for many of those who had the lowest access and reached new highs in 2025. Fifty-six percent of part-time workers (compared to just 26 percent in 2009) and 41 percent of the lowest-paid workers (compared to 21 percent in 2009) now have paid sick days.
But for workers in too many parts of our country and economy, access still depends on what kind of job they hold or how many hours they’re able to work. Only 55 percent of workers in leisure and hospitality, 72 percent in retail and 72 percent in construction have paid sick days. Despite having public-facing jobs that can impact customers’ health, only 55 percent of accommodation and food service workers have paid sick days, and while access is higher in health care and social assistance, one in ten workers does not have paid sick days.. One bright spot is unionized workers, whose ability to collectively bargain and advance workers’ voices contributes to them having more paid sick days than their non-union counterparts.
Women spend an average of nearly 300 hours each, per year, caring for their families, totaling more than $683 billion worth of unpaid care work, and men perform another $413 billion in caregiving annually, but without supportive policies, this can take a toll on their careers. The service sector disproportionately employs women, and particularly women of color, while lacking broad paid sick days access. Many service jobs, such as those in retail and food service, also typically pay low wages, meaning that workers are even less able to afford to miss a shift even when they’re too sick to work safely. In fact, only 41 percent of the lowest-paid workers (those making $15 per hour or less in 2025) have paid sick days. However, paid sick days laws reduce gaps in paid sick days access and increase women’s employment and economic security.
Nearly Six in Ten Workers Still Don’t Have Paid Medical Leave
Just over four in ten workers (42 percent) have paid medical leave through an employer’s short-term disability insurance, according to the new data – a one-point decline from last year. And the most recent available data showed that in 2023, just 27 percent of workers had paid family leave. Without these basic supports, the strain of maintaining a paycheck while managing a serious health condition or caring for a loved one continues to take a toll.
Inequities in access to paid medical leave echo those in access to paid sick days, and in many areas are even starker. Just 24 percent of service workers and 9 percent of the lowest-paid workers have employer-provided paid medical leave, compared to 52 percent of management, professional and related workers, and 66 percent of the highest-paid workers. Small employers often want to provide paid leave but struggle to do so on their own, leaving just 29 percent of employees at small employers with access to paid medical leave compared to 57 percent of those at large employers. Data from 2023 shows similar inequities in, and even lower access to, paid family leave through employers.
Short-term disability insurance, while more common than paid family leave, still remains too rare, particularly for workers in the lowest-paid jobs (9 percent with access), the service sector (24 percent), and construction and extraction jobs (31 percent). Troublingly, access for the lowest-paid workers and among employees of small employers actually declined one point between 2024 and 2025, indicating that public policy changes are necessary not only to expand coverage equitably but ensure it is maintained over time.
Workers and Families Need Lawmakers to Listen and Lead to Solve the Paid Leave Crisis
The will of the public is clear, and the need is urgent. Elected officials at every level – local, state and national – must do more to finally ensure that no working person should ever have to choose between putting food on the table and being there for family during a health crisis. By following the lead of the 14 states with paid family and medical leave programs and 18 states with paid sick days guarantees, the remaining states and Congress can protect public health, keep women in the labor force and protect families’ economic stability when it matters most.
Note: For the second year in a row, the Bureau of Labor Statistics did not publish updated data on access to employer-provided paid family leave. Paid family leave data in the analysis above is from 2023, the most recent available year.
