Sue Ducat
Director of Communications
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Melissa Blair
Robert Wood Johnson Foundation
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Paid Family and Medical Leave

A new policy brief from Health Affairs and the Robert Wood Johnson Foundation examines the debate over guaranteed paid family leave, something only 14 percent of US workers enjoy at the expense of their employer. The United States does have a law—the Family and Medical Leave Act (FMLA) of 1993—requiring some businesses to offer unpaid medical leave to some workers for serious medical and family care needs. However, the United States, along with South Korea, are the only wealthy industrialized countries failing to guarantee paid family leave. This past year saw new efforts to enact a national law, the Family and Medical Insurance Leave (FAMILY) Act, although the law’s future passage is uncertain.

Topics covered by this policy brief include:

  • What’s the background and the law? The brief traces the historic reluctance of US lawmakers and business groups to enact national laws requiring paid leave. The FMLA, which assures many employees up to twelve weeks of unpaid, job-protected leave during a twelve-month period for serious personal or family health needs, marked a turning point because it recognized the dual demands of work and family. The law applies to businesses employing fifty or more people, and the brief spells out its provisions, as well as those in the proposed FAMILY Act. Also, as the brief notes, a dozen states have passed their own laws, many of which provide more rights to workers than the national law.

  • What’s the debate? There are studies, which the brief references and proponents of the FAMILY Act cite, showing that paid leave can increase employee loyalty and reduce staff turnover. Its opponents, the brief notes, don’t dispute these benefits but maintain that paid leave can be best left as a voluntary decision by businesses. The brief reviews both sides of the argument.

  • What’s next? With Republicans controlling both houses of Congress, the FAMILY Act is unlikely to make much progress in the year ahead. However, the brief predicts that proponents of paid leave are likely to ramp up their efforts at the state level—and then-candidate Donald Trump’s proposed paid maternity leave plan might make some headway. The brief also suggests that other social and political issues—such as wage stagnation—could serve as a catalyst to pass laws, including guaranteed paid leave, that help lower- and middle-income families.

About Health Policy Briefs

Health Policy Briefs are aimed at policy makers, congressional staffers, and others needing short, jargon-free explanations of health policy basics. The briefs, which are reviewed by experts in the field, include competing arguments on policy proposals and the relevant research supporting each perspective.

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About Health Affairs

Health Affairs is the leading journal at the intersection of health, health care, and policy. Published by Project HOPE, the peer-reviewed journal appears each month in print and online, with additional Web First papers and health policy briefs published regularly at Read daily perspectives on Health Affairs Blog and customize the content you want to see in Health Affairs Alerts.

About the Robert Wood Johnson Foundation

For more than 40 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are striving to build a national Culture of Health that will enable all to live longer, healthier lives now and for generations to come. For more information, visit Follow the Foundation on Twitter at or on Facebook at