With only 16% of Americans able to access paid leave, whether for personal medical needs or those of a family member, many people face financial stress and ruin when faced with serious illness. While most employers would like to support employees and their families, they often indicate that they do not always have the profit margin to support paid leave. Many employers either cannot or choose not to provide paid leave. For some small businesses, providing paid leave is primarily a financial decision, but for larger, public companies who are beholden to stockholders, it is a decision made to maximize profits. Stuck in between the financial realities of their employers and stockholders, the majority of American workers are just trying to get by and finding it increasingly difficult.
“Laura,” who asked that her name not used, is a 56-year-old woman, recently divorced, working part time at the local plant nursery and also part time for a friend’s business. While she was already having difficulty making ends meet, she was diagnosed with breast cancer. Because both jobs were part time, she had no benefits or any paid leave available to her. She did have health insurance she had purchased through the Affordable Care Act which was a financial strain in and of itself, particularly because she did not qualify for any subsidies. She underwent surgery, chemotherapy, and radiation. At each step, she was unfortunate because she experienced side effects that kept her out of work longer than anticipated. Her blood counts were extremely low and her doctor did not want her to return to work at the plant nursery for an extended period due to the danger of getting a fungal infection from the dirt that her body would not be able to fight.
The owners of the plant nursery were very supportive and understanding and even checked on her from time to time. They did save her job for when she could return, but Laura knew they could change their minds at any time creating unneeded stress as she healed. She reported her frustration with her health, “I want to be someone they can count on. I enjoy my job. Being at work is healthier for me. Being outside…I enjoy the atmosphere.” Like most workers, Laura wants to work and recognizes the emotional benefits of work as well as the obvious financial ones.
Because of the loss of pay and the part of her medical bills insurance did not cover, Laura is finding her financial situation to be even more precarious and stress-inducing. While she has set up a payment plan for her medical bills, the daily stress of trying to make ends meet takes its toll. When asked what would it mean to her both personally and financially if she would have had access to paid leave, she replied, “It would have reduced my stress. I have a personal guilt of having to justify everything that I purchase. I equate in my mind how many hours of work a purchase will cost me. Everything I do is framed with this mindset. It’s exhausting. Even when a friend offered me a free weekend away at her beach house, I had to think very carefully if I could afford the gas to go.” Laura continues to work hard paying off her medical bills, but she finds it challenging and somewhat demoralizing. If she had been able to take paid leave even for part of her illness, her financial situation would not be nearly as dire.
“Joanna,” who also wasn’t comfortable using her real name, is a 30-year-old barista in Durham who left her job in teaching after needing an extended leave from her teaching job last spring due to significant mental health issues. The school’s disability insurer turned down her claim, although her psychiatrist said she could not work due to the anti-psychotic drugs she was taking. Joanna noted that mental health issues are frequently misunderstood and classified differently than physical health concerns, although they are not supposed to be.
Joanna decided that she needed a part time work situation with less stress, so she returned to working as a barista, the job she had before becoming a teacher. However, she knows that this cannot be a long-term job because she has no benefits and does not make enough to save money for retirement. But, for now, this job works for her mental health needs. She recognizes her privilege in being able to take this break from full time work because she comes from an upper middle-class family. She has no student loans because she earned a scholarship and no car payment since a grandparent gifted her a car. She knows that without these advantages, she would be in a much more precarious financial situation.
Joanna shares that her co-workers who have dealt with serious health issues, one in particular needed open heart surgery and had not purchased health insurance, has been out of work for 2 months and had to declare bankruptcy. She reports that he hopes to return to work, but there is no guarantee that his job will be there. Another co-worker is a mother of four who comes into work sick because she cannot afford to miss work. Joanna knows that she needs to find full time employment with benefits in the long term, but she also knows that she may experience additional stress as a result and need to take leave at some point for mental health purposes. If paid leave is not available for mental health issues, she is not sure how she can manage the stress and her financial obligations.
Clearly, the financial needs of a person who is either sick themselves or has a family member who is ill are not met for 83% of civilian American workers. The Family Medical Leave Act (FMLA) does not address the financial issues that taking leave creates. While some may say those who do not have paid leave as a benefit should plan ahead and save for an emergency, we know that many Americans are in low paying jobs that do not allow for saving and live paycheck to paycheck. In addition, the hodgepodge of health insurance coverage makes workers who have a serious illness spin a roulette wheel to find out whether they will face financial ruin. If they or a family member fall ill, there is no social safety net to catch them and they risk becoming indigent.
States that have implemented a paid leave policy have seen positive effects for both employers and employees. According to the National Partnership for Women and Families, “In California, virtually all employers (99 percent) report that the state’s program has positive or neutral effects on employee morale and 87 percent that the state program had not resulted in any increased costs.” Additionally, “small businesses (those with fewer than 50 employees) report more positive or neutral outcomes than large businesses (500+ employees) in profitability, productivity, retention and employee morale.” It is time for a federal paid leave act to make its way through Congress to address this dire need for all American workers.