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. State paid family and medical leave programs are paid for through payroll contributions or deductions paid by workers, employees, or both, also called premiums. Premiums cover the cost of benefits and program administration as well as any required reserve funds. 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 7 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, and a very limited number of studies include analyses of more recent policies in the District of Columbia, Massachusetts, and Washington. 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 sufficiently 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?
No States Newly Implemented Paid Family and Medical Leave This Year
As of September 2025, 14 states (including the District of Columbia) have adopted a paid family and medical leave program, and all provide at least 7 weeks for all parents to bond with a new child. Benefits are currently available to working parents in 10 of the states, and benefits will become available in the remaining four states by 2028.
Although no states began newly implementing paid family and medical leave this year, benefits in existing programs were strengthened because of legislation enacted in previous sessions. Beginning in January 2025, the wage replacement rate in California increased from between 60% and 70% to between 70% and 90% of the worker’s average weekly wage, and the duration of family leave in Rhode Island increased from 6 to 7 weeks.
Over Half of States Introduced Paid Family and Medical Leave Legislation Last Session, but Few Made Progress
In the last year, 30 states introduced legislation to establish or modify a paid family and medical leave program. Although unsuccessful, 16 states introduced legislation which would have established a new statewide paid family and medical leave program, most of which would have provided up to 12 weeks of paid leave for all parents to bond with a new child.
Legislators in Virginia passed a bill to create a statewide paid family and medical leave program of up to 12 weeks for eligible workers to bond with a new child, however, the Governor vetoed the bill. This is the second consecutive veto of a paid family and medical leave bill in Virginia. In Hawaii, legislators considered multiple bills which would have created a statewide paid family and medical leave program this year. Ultimately, legislators enacted a bill to convene a working group to develop recommendations for establishing and implementing a paid family and medical leave program in the state.
All 14 states with existing paid family and medical leave programs introduced legislation to modify their programs, and eight states successfully enacted legislation (discussed below). The modifications ranged from minor technical adjustments in several states to expanding benefits in two states.
Colorado Increased the Duration of Leave for Families with a Baby in the NICU
Legislators in Colorado enacted a bill this session which doubles the paid leave available for families with a baby in the neonatal intensive care unit (NICU). These families will be able to take up to 24 weeks of paid leave while their baby is in the NICU beginning January 2026.
Rhode Island Enacted Legislation to Increase the Wage Replacement Rate
In Rhode Island, legislators enacted companion bills which will increase the wage replacement rate in 2027 and 2028. Workers currently receive about 60% of their average wages while taking leave, and that rate will increase to approximately 70% in 2027 and approximately 75% in 2028. The bill will also increase the contribution wage base and expand the definition of “family member” to include siblings for caregiving purposes beginning in 2026. The contribution wage base is the maximum annual earnings threshold subject to the premium. Rhode Island’s contribution wage base will increase from $89,200 to $100,000.
Maryland Enacted Legislation to Delay Implementation Again
In Maryland, legislators enacted a bill to further delay implementation of the state’s paid family and medical leave program. Initially, premiums were going to be effective in October 2023 with benefits available January 2025. However, in each of the last three legislative sessions, these timelines have been delayed. Premiums are currently scheduled to be effective January 2027 with benefits available to families in January 2028.
5 Other States Enacted Legislation to Modify an Existing Paid Family and Medical Leave Program
Legislators in Connecticut, Delaware, Maine, Oregon, and Washington all enacted bills to make technical changes or adjustments to their existing paid family and medical leave programs. Connecticut, Delaware, and Washington also made more substantial changes.
In Connecticut, legislators enacted a bill to expand the paid family and medical leave program to cover non-certified employees and public and non-public elementary and secondary schools, effective October 2025.
Legislation was enacted in Delaware which requires the state to conduct an actuarial study on the impact associated with changing the paid family and medical leave application period from 24 months to 12 months. Currently, eligible workers can receive up to 12 weeks of benefits (up to 6 weeks for family caregiving leave) in a 24-month period. Delaware is currently the only state with a 24-month application period instead of a 12-month application period.
Washington enacted a bill which expands job protection benefits to those who have been employed at their current employer for at least 180 days, effective January 2026. Previously, only those who had been employed for at least 12 months and worked at least 1,250 hours at a business with 50 or more employees were eligible for job-protected leave.
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.
3 States Considered Alternative Approaches to Paid Leave, but None Passed This Session
Three states (Kentucky, Nevada, and New Mexico) introduced alternative approaches to increasing access to paid leave for parents to bond with a new child without proposing a full statewide program.
Legislators in Kentucky and Nevada introduced bills that would have required certain private employers to provide their employees with paid leave. In Kentucky, employers with 50 or more employees would have been required to provide at least 12 weeks of paid parental leave. Similarly, Nevada’s bill would have required employers with 50 or more employees to provide at least 12 weeks of paid family and medical leave. Nevada’s bill passed the legislature and was vetoed by the Governor. Kentucky’s bill did not pass.
In New Mexico, legislators considered a bill which would have provided up to 6 weeks of “family wellness leave” funded through payroll contributions collected from workers and employers. Family wellness leave would have included medical leave to care for oneself or a family member with a serious health condition, leave pertaining to a family member’s military service, safe leave, bereavement leave, and foster leave for a family welcoming a foster child into their home. Family wellness leave would not have included parental leave to bond with a new child. Instead, the bill would have also created a new “welcome child” benefit, which would have provided one parent with $3,000/month for the first 3 months immediately following the birth or adoption of a child. The bill passed the House but did not advance through the Senate.
States Enacted Legislation to Provide Paid Parental Leave for Eligible State Employees and/or Public School Teachers
In the last year, 13 states introduced legislation to create, expand, or modify paid parental leave benefits for eligible state employees and/or public school teachers. Of those, three states (Alabama, Iowa, and Mississippi) enacted legislation to provide paid parental leave for state employees for the first time. Four states (Arkansas, Maryland, Oklahoma, and Tennessee) enacted legislation to modify existing paid parental leave benefits for state employees and/or public school employees, and two states (Indiana and Wyoming) adopted new paid leave policies or expanded existing policies administratively.
In Alabama, legislators enacted a bill which provides paid parental leave for eligible state employees and public school teachers beginning July 2025. Mothers receive up to 8 weeks of leave and fathers receive up to 2 weeks of leave. Legislators in Iowa enacted a bill to provide eligible state employees with up to 4 weeks of paid parental leave for parents who give birth and up to 1 week for parents who do not give birth beginning in July 2025. In Mississippi, legislators enacted a bill which provides eligible state employees who are primary caregivers with 6 weeks of paid parental leave at full pay effective January 2026.
The governor of Indiana signed an executive order this year to expand paid parental leave for state employees following the birth of a child. Parents who give birth can now take up to 9.75 weeks of leave, and all other parents can take up to 3.75 weeks of leave. In January 2025, Wyoming adopted a new administrative policy to provide eligible state employees with up to 6 weeks of paid family and medical leave for the first time.
Additionally, legislators in Arkansas, Maryland, Oklahoma, and Tennessee also enacted bills to make minor modifications to paid parental leave for state employees and/or public school teachers.
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 September 2025, states offer between 7 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. As of January 2025, New York also provides an additional 20 hours of paid sick leave specifically for prenatal care. 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 flat percentage of their average weekly wages ranging from 70% 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 September 2025, maximum weekly benefits range from $900 in Delaware to $1,681 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 in 2024). Weekly benefits for these workers range from $759 in Rhode Island to $1,064 in California. 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 January 2025. 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 September 2025, paid family and medical leave premium rates range from 0.39% to 1.3% 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 $176,100 in annual earnings in 2025). Rhode Island currently has the lowest contribution wage base, but due to legislation enacted in the last year, the wage contribution base will increase from $89,200 to $100,000 in annual earnings beginning in 2026.
Covered Workers
State policy choices regarding 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. Eight states 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 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.
Voluntary Paid Leave Insurance Program Models and Private Insurance Coverage
As of September 2025, eight states have 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) followed suit. In 2024, two additional states (Kentucky and South Carolina) 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 beginning in July 2024. Individual workers, including those who are self-employed, were able to purchase individual coverage beginning in July 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.
More than Half of States Provide Paid Parental Leave to Eligible State Employees
As of September 2025, 33 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 September 2025, 20 states have laws known as preemption laws that prohibit localities from adopting and implementing their own paid family and medical leave laws.
View our Policy Impact Calculator, which illustrates how policies, such as state minimum wage, paid family and medical leave, out-of-pocket child care expenses, taxes and tax credits, as well as federal nutrition benefits, interact to impact overall household resources.
ADDITIONAL RESOURCES
View a summary of paid family and medical leave policies across states here. (Coming soon)
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. W., Short, S. E., & Galarraga, O. (2021). Association Between Rhode Island’s Paid Family Leave Policy and Postpartum Care Use. Obstetrics and Gynecology (New York. 1953), 137(4), 728–730. 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]
