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National Paid Family and Medical Leave May be on the Horizon

By Matt Devino, MPH


September 24, 2021
Health Policy

Despite the havoc it has caused, our continuously unfolding public health emergency has given us hope that some elusive policy initiatives are now not the stretch they once were. For example, the pandemic has accelerated the demand for policy-based healthcare reform. At the urging of health advocates across the globe, in 2020, the U.S. government stepped up to protect patients and workers with paid family leave in a bid to slow the spread of COVID-19. 

Only about one-fifth of the U.S. workforce has access to paid family leave, and only two out of five U.S. workers have short-term disability insurance through their employer. When I previously worked as a case manager for patients and their families, their need for paid family leave was evident: their health benefits did not come close to covering their needs. Expanded access to sick and medical leave is often cited by patients, families, and their care teams as “lifesaving.” Many patients with cancer are at significant risk of losing access to their treatment when their wages and benefits are endangered.  And the pressure to continue working while sick can cause patients to miss office appointments. Many patients and caregivers have dropped out of school, lost their jobs, and/or dealt with the grief of not being able to spend enough time with sick loved one(s).

The Pandemic Ushers Change

The temporary expansion of paid family leave was made possible by the Families First Coronavirus Response Act  and then the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Signed into law in March 2020, the CARES Act included provisions that expanded access to sick and paid medical leave. This is significant in the United States, which is often cited as the only industrialized country in the world that does not guarantee universal access to wage protection. The wage protection expansion (which expired at the end of 2020) applied to any employer with more than 50 but less than 500 employees. The expansion was specific to employees who experienced a COVID-19-related emergency. This allowed many people infected with COVID-19 to stay home for two weeks and recover without losing income. Impacted employers were reimbursed for this leave with federal tax credits. This legislation also provided some extended wage protection for up to 10 weeks for employees on medical leave.

While this historic expansion of wage protection is laudable, much more needs to be done. Newly energized, advocates are rallying hard for more wage protection, leveraging the fact that it proved indispensable in combatting the spread of COVID-19. 

ACCC’s Advocacy Commitment

By design, the U.S. government asks for input and comments from outside groups to guide new policy. Congressional members cannot be experts in every domain that public policy touches. Paid family and medical leave is a specific area in which public policy can positively affect the already overburdened oncology workforce, patients, and caregivers.

Congress and the Administration are currently developing a new federally sponsored program that would allow individuals to take paid time off to care for a new child, receive medical treatment, recover from a serious illness or condition, or care for a loved one. These provisions are currently included in the upcoming budget reconciliation bill. The proposed program meets many of the suggested standards included in a letter recently signed by ACCC and other stakeholders.

The letter, which lists 11 provisions to be included in any proposed paid leave program, includes statements such as, “Leave should include meaningful compensation/wage replacement in an amount that allows employees, including lower-income workers, to reasonably afford to take needed leave,” and, “A paid leave program must ensure job protection and use of leave must not result in any adverse employment consequences.” If the current language makes it through the reconciliation process unscathed, the resulting program will become the first national wage protection program in the nation’s history. ACCC also recently signed another letter that echoes these same principles, urging Congress to authorize and fund a national paid family and medical leave program.

 

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