PAID FAMILY AND MEDICAL LEAVE
WHAT IS PAID FAMILY AND MEDICAL LEAVE AND WHY IS IT IMPORTANT?
Paid family leave policies allow workers to take time off work and receive a portion of their salary for qualifying reasons, which include the birth, adoption, or fostering of a child or caring for a loved one with a serious medical condition. Paid medical leave policies allow workers to take paid time off to recover from one’s own serious medical condition, which includes childbirth. The most rigorous research to date shows a state policy that provides at least 12 weeks of paid leave for parents who give birth and at least 6 weeks for all other parents with a new child leads to positive impacts.
Although programs have similar features, no two states’ paid family and medical leave programs are exactly alike. Among the 14 states (including the District of Columbia) that have enacted a paid family and medical leave program, all parents are allowed to take between 6 and 12 weeks off work to bond with a new child. Parents who give birth are often also able to take additional weeks of medical leave to recover from childbirth, and five states provide additional prenatal leave as well. States also vary in the portion of workers’ wages received while on leave, eligibility requirements, job protection provisions, and funding mechanisms.
Without Paid Family and Medical Leave, Most Parents Only Have Access to Unpaid Leave
Fewer than one in three Americans lives in a state with a fully implemented state paid family leave program.1 In states without paid family and medical leave, the primary access to leave for most new parents is through the federal Family and Medical Leave Act (FMLA), which allows qualifying workers to receive 12 weeks of unpaid, job-protected leave with continuous health coverage.2,3 Only 56% of workers qualify for the FMLA,4 and the policy largely benefits higher-income and White workers.5 Because the FMLA provides only unpaid leave to eligible workers, many parents with low incomes may not use the time off or may shorten the duration of leave to avoid losing wages.
In 2022, Congress passed the Pregnant Workers Fairness Act (PWFA), which closed key gaps in the FMLA for parents who give birth. The PWFA requires employers with 15 or fewer employees to make reasonable accommodations for employees who have a known limitation due to pregnancy, childbirth, or related medical condition unless the accommodation poses an undue hardship to the employer. Accommodations include providing unpaid, job-protected leave. Although the PWFA dramatically expanded access to job-protected leave for workers employed at small businesses, it only covers parents who give birth and is still unpaid leave.
Paid Leave to Bond with a New Child Keeps Parents Working and Supports the Health and Wellbeing of Children and Parents
By providing parents with the time and financial security to stay home to bond with a new child, state paid family and medical leave can improve the economic security of the family and keep parents engaged in the workforce.6,7 Paid family and medical leave also supports child and parental health and wellbeing. The programs help new parents have more time to bond with their babies, develop positive caregiving skills, and build the foundation for healthy attachment.8 Further, parents may be better able to seek timely and preventative health care for themselves and their children.9,10
Search the Prenatal-to-3 Policy Clearinghouse for an ongoing inventory of rigorous evidence reviews, including more information on paid family and medical leave.
WHAT IMPACT DOES PAID FAMILY AND MEDICAL LEAVE HAVE AND FOR WHOM?
Paid family and medical leave policies that provide at least 12 weeks of paid leave for parents who give birth and at least 6 weeks for all other parents with a new child increase the likelihood and length of leave-taking, increase mothers’ labor force participation, reduce postneonatal infant mortality, improve parents’ mental health, and foster better child-mother relationships and child health.
The threshold of the number of weeks of leave necessary to impact wellbeing is based on comprehensive reviews of rigorous causal studies. Most of the rigorous causal evidence assessed the efficacy of California’s paid family leave program. When California’s paid family leave program was implemented in 2004, it provided 6 weeks of paid leave for the first time to parents who do not give birth and built upon an existing Temporary Disability Insurance program to extend benefits to parents who give birth from 6 to 12 weeks. At the time, the wage replacement rate was set at 55%, up to a maximum benefit amount.
Some studies also consider the effects of New Jersey, New York, and Rhode Island’s paid family leave laws that were all in effect by 2018. Although most states with paid family and medical leave programs now offer up to 12 weeks of paid leave for all parents to bond with a new child, these longer programs have not yet been rigorously studied to indicate if they provide additional benefits to parents and children.
More Research Is Needed to Determine the Potential of Paid Family and Medical Leave to Reduce Disparities
Some evidence suggests that access to paid family and medical leave may have a greater impact for women of color than for White women, but additional research is needed to understand the full potential of paid family and medical leave programs to reduce disparities across outcomes.
For outcomes such as family leave-taking and household resources, access to paid family and medical leave reduces known racial disparities.11,12 Additionally, access to paid family and medical leave leads to better outcomes for women of color for postpartum psychological distress and receipt of postpartum care.13,14 Research finds that access to paid family and medical leave has no impact on reducing racial disparities in adverse birth outcomes, however.15,16
For more information on what we know and what we still need to learn about paid family and medical leave, see the evidence review on paid family and medical leave.
WHAT PROGRESS HAVE STATES MADE IN THE LAST YEAR TO ADOPT AND FULLY IMPLEMENT PAID FAMILY AND MEDICAL LEAVE?
Paid Family and Medical Leave Benefits Became Available to Families in Colorado This Year
This year, one state—Colorado—began fully implementing its paid family and medical leave program. Colorado became the first state to adopt a paid family and medical leave program through a ballot measure when voters approved Proposition 118 in November 2020. On January 1, 2024, Colorado began providing 12 weeks of paid leave for all parents to bond with a new child, as well as an additional 4 weeks of prenatal or postnatal leave for parents who give birth.
As of October 1, 2024, 14 states (including the District of Columbia) have adopted a paid family and medical leave program, and all provide at least 6 weeks for all parents to bond with a new child. Benefits are currently available to working parents in 10 of those states, and benefits will become available in the remaining four states in 2026.
Over Half of States Introduced Paid Family and Medical Leave Legislation Last Session
In the last year, 27 states introduced legislation to establish or modify a paid family and medical leave program. Although unsuccessful, 15 states introduced legislation which would have established a new paid family and medical leave program. Of these, all but three states introduced at least one bill that would have provided up to 12 weeks of paid leave for all parents to bond with a new child, and three of these states introduced bills that would have provided even more than 12 weeks of benefits.
Additionally, 12 states introduced legislation to modify their existing paid family and medical leave programs, and eight states successfully enacted legislation (discussed below). The changes varied from minor technical adjustments in several states to increasing the duration of leave in Rhode Island.
3 States Made Significant Progress to Advance Paid Family and Medical Leave Last Session
Although no state enacted legislation to newly adopt a paid family and medical leave program over the last year, several states made significant progress. In Virginia, legislators passed a bill, which would have created a paid family and medical leave program providing up to 8 weeks of paid leave for eligible workers to bond with a new child, however, the Governor vetoed the bill. In New Mexico, legislators nearly passed a bill, which would have created a paid family and medical leave program providing up to 12 weeks of paid leave. The bill advanced through the Senate but narrowly failed in the House. Additionally, a bill which would have created a 16-week paid family leave program in Hawaii advanced through the Senate but stalled in House committees. Hawaii’s paid family leave program would have built upon an existing Temporary Disability Program, which already provides medical leave.
Although the legislation did not make as much progress this session, legislators in Pennsylvania considered two bills which would have created a paid family and medical leave program providing up to 20 weeks of paid leave for eligible workers to bond with a new child. As of October 1, 2024, both bills had advanced through committee with bipartisan support, but neither bill had passed.
Rhode Island Enacted Legislation to Increase the Duration of Leave to 8 Weeks
In Rhode Island, legislators enacted companion bills which will increase the duration of paid family leave from 6 to 7 weeks in 2025 and to 8 weeks in 2026. Among the states that have adopted paid family and medical leave programs, Rhode Island currently offers the shortest duration of paid family leave.
Rhode Island’s program also provides an additional dependent allowance for workers with children under 18, effectively increasing the weekly benefit for families with more children at home. The bill will increase the minimum dependent allowance from $10 per dependent each week of leave to $20 per dependent, effective January 1, 2025.
Maryland Enacted Legislation to Delay Implementation Again
In Maryland, legislators enacted companion bills to further delay implementation of the state’s paid family and medical leave program. Initially, premiums were going to be effective on October 1, 2023, and benefits were going to be available on January 1, 2025. However, because of legislation to push back these timelines enacted during the 2023 and 2024 sessions, premiums will now be effective in July 2025 and benefits will become available to families in July 2026.
6 Other States Enacted Legislation to Modify an Existing Paid Family and Medical Leave Program
Lawmakers in California enacted two bills to make paid leave benefits more accessible for eligible workers in the state. One of the bills will remove a provision that allows employers to require their employees to use up to 2 weeks of accrued vacation time before accessing paid family leave benefits, effective January 1, 2025. The other bill will allow workers to file a paid family or medical leave claim up to 30 days in advance. This change will be incorporated in the state’s next upgrade of its integrated claims management system.
Connecticut made several changes to its paid family and medical leave program, effective October 1, 2024. These changes included adding “federally recognized tribe” to the definition of an employer; requiring health care providers to display informational posters about the program; making technical changes related to benefit overpayments; and extending safe leave protections to sexual assault survivors. Connecticut also enacted legislation to make other technical adjustments to the program.
In addition to making minor technical adjustments to its existing paid family and medical leave program, Oregon enacted legislation which allows the state to periodically assess the solvency of its paid family and medical leave trust fund, and if necessary, reduce the number of weeks available to families (except for paid bonding leave). Colorado, Delaware, and Minnesota also enacted legislation to make minor technical adjustments to their existing paid leave programs.
Lastly, New York included a provision in the final enacted Fiscal Year 2025 budget to provide eligible workers an additional 20 hours of paid sick leave for prenatal care, effective January 1, 2025.
For more information on the state policy levers to help maximize the effectiveness of a state paid family leave program see our State Policy Lever Checklists.
States Enacted Legislation to Expand Paid Parental Leave for Eligible State Employees and/or Public School Teachers
In the last year, 11 states introduced legislation to create or expand paid parental leave benefits for eligible state employees and/or public school teachers. Of those, two states (Georgia and Utah) enacted legislation to expand their state employee programs, and two states (North Carolina and Pennsylvania) adopted an administrative policy to expand existing benefits.
In Georgia, legislators enacted a bill which increased the duration of paid parental leave for eligible state employees from 3 to 6 weeks, effective July 1, 2024. The bill also expanded coverage to include public school employees. Legislators in Utah enacted several bills which expand paid parental leave benefits for eligible state employees by providing coverage for foster parents, allowing postpartum recovery leave to be taken intermittently, and requiring public schools provide eligible employees with 3 weeks of paid postpartum recovery leave after they give birth, beginning July 1, 2027. Currently Utah provides eligible state employees with 3 weeks of paid postpartum recovery leave for parents who give birth and 3 weeks of paid parental leave (available to all parents), which can be combined for up to 6 weeks of paid leave for parents who give birth.
North Carolina and Pennsylvania expanded their existing paid parental leave benefits for state employees administratively. In 2023, North Carolina temporarily expanded parental leave to eligible public school employees, and in 2024, the state Board of Education approved a final rule which made the benefit permanent, effective October 1, 2024. On February 15, 2024, the Pennsylvania Office of Administration adopted a new policy, which increased the duration of paid parental leave for eligible state employees from 6 to 8 weeks, effective the same day.
Additionally, because of enacted legislation or administrative changes in 2023, Florida, Louisiana, Nevada, and Oklahoma now provide paid leave for eligible state employees and/or public school teachers to bond with a new child.
2 Additional States Allow Voluntary, Private Paid Leave Insurance Programs
In the last year, two states (Kentucky and South Carolina) enacted legislation to authorize private insurance companies to sell paid family leave insurance. These private insurance plans often place the cost burden on workers and have few regulations on the type of policy that may be offered. Virginia was the first state to enact this type of policy in 2022, and in 2023, five more states (Alabama, Arkansas, Florida, Tennessee, and Texas) enacted similar legislation.
Additionally, New Hampshire and Vermont have voluntary paid leave programs. These voluntary programs require private sector workers to opt in, meaning they do not guarantee access to paid leave for most workers in the state. New Hampshire fully implemented the Granite State Paid Family Leave Plan with up to 6 weeks of benefits in August 2023. The program is unique in that it is administered through the private insurance market and is optional for private sector employers and employees, although state employees are automatically enrolled in the program. In Vermont, private employers could voluntarily purchase a paid family and medical leave insurance policy for their employees on July 1, 2024. Individual workers, including those who are self-employed, will be able to purchase individual coverage beginning on July 1, 2025. State employees are also automatically covered under Vermont’s program.
Policy progress has outpaced the research on private and voluntary programs, and thus, the impact of these programs for children and family outcomes remains unclear. As private and voluntary programs are implemented, research is needed to explore the equity and impacts of this approach to paid leave in states.
For more information on each state’s progress on paid family and medical leave, find our individual state summaries under Additional Resources below (and here).
HOW DOES PAID FAMILY AND MEDICAL LEAVE VARY ACROSS THE STATES?
States’ paid family and medical leave programs vary in the number of weeks offered, the portion of workers’ wages that are paid, eligibility requirements, job protection provisions, and funding mechanisms. We outline the variation in policy choices among the 14 states (including the District of Columbia) that have enacted statewide paid family and medical leave programs, regardless of whether those programs have been fully implemented yet.
Duration of Leave
As of October 1, 2024, states offer between 6 and 12 weeks of paid family and medical leave for all parents to bond with a new child. In 10 states, parents who give birth can receive additional weeks of leave by taking paid medical leave to recover from childbirth followed by paid family leave to bond with their new child. The number of weeks of medical leave depends on the type of birth (typically 6 weeks for vaginal delivery and 8 weeks for cesarean delivery).
Some states also offer specific leave for the prenatal period, separate from medical leave, to allow workers to attend routine medical appointments during pregnancy without sacrificing their paycheck. Currently, Colorado, Connecticut, the District of Columbia, Oregon, and Washington provide designated prenatal leave, ranging from 2 to 4 weeks. New York will provide an additional 20 hours of paid sick leave for prenatal care beginning on January 1, 2025. The federal Family and Medical Leave Act (FMLA) also provides eligible workers with unpaid pregnancy-related leave that is medically necessary, including intermittent leave for prenatal doctor visits.
Wage Replacement
Paid family and medical leave benefits encompass wage replacement and job protection benefits. In five states, workers are paid a set percentage of their average weekly wages ranging from 60% to 85%, depending on the state. The remaining nine states provide a marginal-rate wage replacement structure in which workers who earn lower wages receive a greater portion of their wages than higher earners. In these states, wage replacement rates for lower income brackets range from 60% to 100% of average weekly wages, and wage replacement rates in higher income brackets range from 50% to 66% of average weekly wages. In all states, weekly benefits are capped, and, as of October 1, 2024, maximum weekly benefits range from $900 in Delaware to $1,620 in California.
Projected Weekly Benefits for Parents with a New Child
To draw comparisons across states that calculate benefits differently, we project the paid family and medical leave benefits available for all parents to bond with a new child in each state. In some states, parents who give birth may stack available family leave with medical leave, resulting in a longer duration of benefits (indicated by the star in the chart below). The projected benefits are for a full-time worker earning the national median wage (about $61,440 per year). Weekly benefits for these workers range from $709 in California to $1,016 in Oregon. For states that have not yet implemented their paid family and medical leave programs, we project what benefits would be if the program had been active in 2024. We estimate states’ total paid leave benefits by multiplying the maximum number of weeks of paid family leave offered in each state by the weekly benefit.
Job Protection Benefits
Job protection benefits require that a worker is placed in the same position, or a comparable position, when the worker returns from leave. All states offer job protection benefits to at least some workers while they are on paid leave. The federal FMLA and the PWFA provide unpaid, job-protected leave for eligible workers. To fill in any gaps and ensure more workers are covered, states offer additional job protection benefits to certain workers covered under their paid family and medical leave laws.
Some states apply the same eligibility criteria to wage replacement and job protection benefits, making job protections portable across employers. However, similar to the FMLA, some states require a worker to be employed with their current employer for a certain period of time (currently ranging from 90 days to 12 months) to qualify for job-protected leave. Additionally, in some states, job protection benefits come from a separate law than the law providing the cash benefit for paid leave, which most often means that only workers employed at an employer of a certain size are qualified for job-protected leave, and the full duration of allowable paid leave might not be protected. In addition, two states (New York and Rhode Island) only guarantee job protections for family leave, not medical leave. This degree of variation can make it challenging for workers to understand which protections they have while taking paid leave.
Program Funding Mechanisms
State paid family and medical leave programs are funded through worker and/or employer contributions (also called premiums) collected by the state via payroll deductions. Workers and employers share the cost of paid family and medical leave in 10 states, and workers cover the full cost in three states. In the District of Columbia, employers cover the full cost of the program. Most states apply a joint premium for both paid family and medical leave, however, in four states (Massachusetts, New Jersey, New York, and Washington) the funding structure varies depending on the type of leave such that workers cover the full cost of family leave, whereas workers and employers share the cost of medical leave.
As of October 1, 2024, paid family and medical leave premium rates range from 0.37% to 1.2% of all covered employees’ wages, typically up to a specified wage base (i.e., the contribution wage base). This means that any wages above the specified limit are not subject to the premium. Most states apply the same contribution wage base for paid family and medical leave as is used for Social Security (up to $168,600 in annual earnings in 2024). Beginning January 1, 2024, California began collecting premiums on all wages, regardless of income level.
Covered Workers
State policy choices surrounding who is eligible to take leave, as well as the automatic (versus opt in) nature of the coverage, can have implications for equitable access to and take up of paid family and medical leave programs. Colorado, Connecticut, Maine, Maryland, Minnesota, New Jersey, Oregon, and Washington cover almost all employees (private, public, and domestic) in their paid family and medical leave programs.
Public sector employees are not always automatically covered by a state’s paid family and medical leave program, but most states allow public sector employees to opt in to coverage. The District of Columbia does not cover public sector employees in its paid family and medical leave program, but the District does provide eligible District employees with similar benefits. Self-employed workers can opt in to coverage in all states that have a paid family and medical leave program, except for New Jersey and Rhode Island.
Only Delaware requires that employees (public, private, and domestic) must work for an employer with a certain number of employees to be covered.
More than Half of States Provide Paid Parental Leave to Eligible State Employees
As of October 1, 2024, 27 states that have not implemented a statewide paid family and medical leave program offer paid parental leave to eligible state employees. The District of Columbia and New York have statewide programs and also provide separate paid parental leave benefits to certain state employees. In addition, some statewide paid family and medical leave programs automatically cover public employees. Similar to statewide leave programs, state employee programs vary in who is covered, length of leave, and wage replacement. The benefits range from 2 to 12 weeks, and state employees often receive full pay while on leave.
Almost Half of States Have Preemption Laws, Prohibiting Localities from Establishing Paid Family and Medical Leave
As of October 1, 2024, 20 states have laws known as preemption laws that prohibit localities from adopting and implementing their own paid family and medical leave laws.
ADDITIONAL RESOURCES
NOTES AND SOURCES
- Prenatal-to-3 Policy Impact Center calculations using US Census Bureau, Population Division. (2024). Annual estimates of the resident population for the United States, regions, states, District of Columbia, and Puerto Rico: April 1, 2020 to July 1, 2023 [Data Set]. Retrieved September 11, 2024 from https://www.census.gov/data/tables/time-series/demo/popest/2020s-state-total.html
- United States Department of Labor, Wage and Hour Division. Family and Medical Leave Act. https://www.dol.gov/agencies/whd/fmla
- Cornell Law School. Legal Information Institute. Definition of eligible employee under the Family and Medical Leave Act. https://www.law.cornell.edu/cfr/text/29/825.110
- Brown, S., Herr, J., Roy, R., & Klerman, J. A. (2020). Employee and Worksite Perspectives of the FMLA: Who is Eligible? Abt Associates Inc. & U.S. Department of Labor, Chief Evaluation Office. https://www.dol.gov/sites/dolgov/files/OASP/evaluation/pdf/WHD_FMLA2018PB1WhoIsEligible_StudyBrief_Aug2020.pdf
- Bartel, A., Kim, S., Nam, J., Rossin-Slater, M., Ruhm, C., & Waldfogel, J. (2019). Racial and ethnic disparities in access to and use of paid family and medical leave: Evidence from four nationally representative datasets. Monthly Labor Review,1-29. Retrieved July 8, 2020, from jstor.org/stable/26603839
- Appelbaum, E. & Milkman, R. (2011). Leaves that pay: Employer and worker experiences with paid family leave in California. Center for Economic and Policy Research. http://cepr.net/publications/reports/leaves-that-pay
- Setty, S., Skinner, C. & Wilson-Simmons, R. (2016). Protecting workers, nurturing families: Building an inclusive family leave insurance program. National Center for Children in Poverty. http://nccp.org/publications/pdf/text_1152.pdf
- Ruhm, C. J. (2011). Policies to assist parents with young children. The Future of Children, 21, 37–68. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202345/#__ffn_sectitle
- National Partnership for Women and Families. (2019). Paid leave works: Evidence from state programs. http://www.nationalpartnership.org/our-work/resources/economic-justice/paid-leave/paid-leave-works-evidence-from-state-programs.pdf
- Zero to Three & National Partnership for Women and Families. (2018). The child development case for a national paid family and medical leave program. http://www.nationalpartnership.org/our-work/resources/economic-justice/paid-leave/the-child-development-case-for-a-national-paid-family-and-medical-leave-insurance-program.pdf
- Rossin-Slater, M., Ruhm, C., & Waldfogel, J. (2013). The effects of California’s paid family leave program on mothers’ leave-taking and subsequent labor market outcomes. Journal of Policy Analysis and Management, 32(2), 224–245. https://doi.org/10.1002/pam.21676 [Paid Family and Medical Leave Evidence Review Study N]
- Lenhart, O. (2021). The effects of paid family leave on food insecurity – evidence from California. Review of the Economics of the Household. https://doi.org/10.1007/s11150-020-09537-4 [Paid Family and Medical Leave Evidence Review Study Y]
- Doran, E., Bartel, A., Ruhm, C., & Waldfogel, J. (2020). California’s paid family leave law improves maternal psychological health. Social Science & Medicine, 256, 1-8. https://doi.org/10.1016/j.socscimed.2020.113003 [Paid Family and Medical Leave Evidence Review Study T]
- Steenland, M., Short, S., Galarraga, O. (2021). Association between Rhode Island’s paid family leave policy and postpartum care use. Obstetrics & Gynecology [Online ahead of print]. https://doi.org/10.1097/aog.0000000000004303
- Choudhury, A. (2020). Long term impact of California’s paid family leave policy on breastfeeding. The Empirical Economics Letters, 19(1), 43-53. https://www.researchgate.net/publication/341767260_Long_Term_Impact_of_California’s_Paid_Family_Leave_Policy_on_Breastfeeding
- Montoya-Williams, D., Passarella, M., & Lorch, S. (2020). The impact of paid family leave in the United States on birth outcomes and mortality in the first year of life. Health Services Research, 1-8. https://doi.org/10.1111/1475-6773.13288 [Paid Family and Medical Leave Evidence Review Study S]
