In the six and a half years since a global pandemic rocked the economy and took the lives of more than 1 million people in the U.S., 10 states have enacted or expanded access to paid sick leave. This year, Virginia became the first Southern state to enact paid sick leave, bringing the total number to 19 states, including the District of Columbia, which have passed paid sick leave laws along with at least 18 local jurisdictions. Now a record 83 percent of all civilian workers – including 81 percent of private sector workers – have access to paid sick leave. For these workers, getting sick doesn’t mean losing income or still having to come in and risk infecting their colleagues – but not everyone is so lucky.
The record high share of workers with access to paid sick leave can be misleading in an economy as large as the United States’. There are still nearly 25 million workers who lack dedicated paid time off to be used when they are ill, need to access medical care or need to care for a sick loved one. The vast majority of these workers are in the private sector, but more than 1.4 million state and local government employees also lack paid sick leave.
Despite the growing number of state and local paid sick leave laws, access remains uneven. Who are the workers being left behind? Notably, the different groups of workers without access to paid sick leave tend to overlap and are more likely to be comprised of women and workers of color.
Workers without the benefit of a union are less likely to have paid sick leave
State and local government workers are 12 percentage points more likely to have access to paid sick days than private sector workers, in part because they are so much more likely to be represented by labor unions. Among private sector workers, belonging to a union increases paid sick leave access by 8 percentage points (20 percent of nonunion private sector workers lack paid sick days, compared to just 12 percent of union workers).
Women are less likely than men to be members of unions, putting them at a disadvantage if they don’t live in a jurisdiction covered by a paid sick leave law.
Part-time workers often lack paid sick days
People who work part time are among the least likely to have access to paid sick days, particularly in the absence of legal protections. The share of workers without paid sick leave benefits has declined over time, but 41 percent of part-time workers in the private sector still don’t have access to paid sick leave.
Women are much more likely to work part time, and white, Asian and Latina women are all roughly twice as likely to be employed part time compared to men of the same race or ethnicity. Black workers are the exception because Black women are the least likely to work part time compared to women of other races, while Black men are the most likely.
Many low-paid workers don’t have access to paid sick days
The lower a workers’ pay, the less likely they are to have access to paid sick days. Thirty-nine percent of workers in the bottom 25th percentile of wages – those paid less than $19 per hour or about $40,000 per year if working full-time, year round – do not receive paid sick leave. But access climbs rapidly as hourly pay increases; only 3 percent of workers in the top 10th percentile of wages – those paid at least $62.80 per hour or just over $130,000 annually if working full-time, year-round – go without access to paid sick time.
Women and Black and Latino workers of all genders have lower average wages relative to men and white workers. Women make up nearly two-thirds of workers paid $7.25 an hour or less, most of whom are adults over the age of 25.
Workers in certain types of jobs are less likely to have paid sick days
Everyone gets sick sometimes and everyone should be able to access medical care when they need it, but access to paid sick leave too often depends on the type of job someone holds. It isn’t hard to understand the benefits of paid sick leave for hospital workers, given the health risks to themselves and to vulnerable patients; if anything, it’s somewhat surprising that 4 percent lack access. But for many workers who need it most, paid sick leave is unavailable. Paid sick days are a particularly important tool to help reduce the spread of foodborne illnesses, especially in light of recent outbreaks and recalls. But 42 percent of private sector workers in accommodation and food services – the people cleaning hotel rooms and cooking and serving food – have no access to paid sick leave. Neither do 26 percent of retail workers, another group that regularly interacts with the public as part of their jobs yet cannot take paid time off to recover when they are sick.
Women hold the majority of jobs in the accommodation and food services industry, and workers of color are also overrepresented. It is also the industry with the lowest average wages and one of the highest rates of part-time work hours. But state paid sick day laws reduce gaps in access and increase women’s employment and economic security. Women working in the service sector are particularly disadvantaged when it comes to paid sick leave benefits, with one study finding they are 10 percentage points less likely than men to have access to paid sick days, but local paid sick leave laws significantly reduced that gap.
States have been driving progress but it’s time for Congress to ensure workers across the nation have paid sick leave
In 2011, when CT passed the first state-level paid sick leave law, only 63 percent of private sector workers had access to paid sick leave. As additional states and localities continued to pass their own laws over the years, coverage increased.
State and local laws have had a meaningful impact on increasing workers’ access to paid sick days. Today, roughly 47 percent of all workers live in a state or jurisdiction covered by a paid sick leave law.
For example, from 2016 to 2026, paid sick days access in the Mountain Division (Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah and Wyoming) went from 60 percent to 88 percent, a 28 percentage point increase. Why? Because over the course of the last decade three states – Arizona, Colorado, and New Mexico – passed paid sick leave laws, covering more than 58 percent of all workers in the region. In contrast, over the same time period in the East South Central Division (Alabama, Kentucky, Mississippi, and Tennessee) no state paid sick days laws have been passed and workers’ access to paid sick leave has declined in this region, from 65 percent in 2016 to 59 percent in 2026. Even more troubling, local governments have been blocked from passing their own laws in 18 states that are home to 57 percent of Black women workers.
States where workers have no legal right to paid time off when they are sick represent many of the workers who would have the most to gain from paid sick leave access, from better health to higher household income and lower poverty rates to fewer bankruptcy filings. But in the absence of a federal policy solution, these workers will continue to be left behind through no fault of their own. Workers and families need their elected officials at every level to protect their economic wellbeing and public health by expanding access to paid sick leave.
Note: The Bureau of Labor Statistics has changed how it reports on access to employer-provided paid family leave and replaced the old series with a new category of paid family and medical leave. This more closely resembles the structure of existing state social insurance programs and the federal proposal introduced in the FAMILY Act. As of March 2026, 50 percent of all civilian workers are reported to have access to paid family and medical leave through their employer, including 49 percent of private sector workers and 57 percent of state and local workers. More analysis on the new data addition is forthcoming.
