In a government shutdown, hundreds of thousands of federal workers are on leave without pay for the duration of the shutdown (and possibly worse, if the threatened layoffs occur). If history is a guide (though no guarantee), federal workers will receive back pay after the shutdown ends, but often federal contractors do not. But federal workers aren’t the only ones who go through periods of not being paid while they’re employed. Thousands of workers go without pay every year when they need to take sick time to care for themselves and their families. While the number of workers with access to paid sick time has markedly improved over the last decade because of state and local action, access remains highly unequal, depending on where workers live and how much they are paid.

Access to paid sick leave is increasing in some areas

On a national level, we’ve seen positive trends in access to paid sick days from 63% of private-sector workers in 2012 to a record high of 80% in 2025, according to the latest data from the Bureau of Labor Statistics. These advances are driven by the fact that state and local governments enacted laws to enable workers to earn paid sick leave. In 2024, ballot measures were passed in Alaska and Nebraska. Alaska’s leave policy took effect on July 1, while Nebraska’s took effect just last week (albeit weaker than originally passed). Unfortunately, a paid sick leave measure that Missouri voters overwhelmingly approved by ballot was rolled back by the legislature and is no longer in effect.

Currently 18 states (including Washington, D.C.), 17 cities, and 4 counties have some form of paid sick leave requirements. Given that the existence of state laws varies, it’s no surprise that there are significant differences in access to paid sick time across the country, as shown in Figure A. The share of workers with access to paid sick days ranges from only 63% in the East South Central states (Alabama, Mississippi, Kentucky, and Tennessee) and 71% in the West South Central (Arkansas, Louisiana, Oklahoma, and Texas) up to 98% in the Pacific states (California, Oregon, Washington, Hawaii, and Alaska). The fact that the nearly 30 million workers in the Pacific states have essentially universal access to at least some form of paid sick days highlights that this key labor standard is purely a policy choice—and one that state and local governments can enforce on their own.

Figure A

Notably, many state governments in the East South Central and West South Central Census divisions have passed preemption laws prohibiting local municipalities from passing paid sick leave policies. So not only have legislative majorities failed to enact paid sick leave at the state level, but these states have also blocked cities and counties from passing legislation to provide paid sick leave for their workers.

Access to paid sick leave is greatest for the most highly paid workers

As with geographic variation, access to paid sick leave remains vastly unequal by wage level. As shown in Figure B, the higher the wage, the greater the access to paid sick leave. Among the 10% of private-sector workers with the highest wages, 96% have access to paid sick days. By contrast, among the 10% of workers with the lowest wages, only 41% have access to paid sick days.

Figure B

The unequal access to paid sick days is particularly troubling since low-wage workers are least able to absorb lost wages when they or their family members are sick. Workers may have trouble paying for housing, food, health care, and other necessities (see Table 1 of this report). This unequal access is why state laws are so important: Most of the gains from state and local paid sick provision benefited the lowest-wage workers. Access for the bottom 10% of wage earners increased from 19% in 2012 to 41% in 2025.

There is also huge variation in access to paid sick days within the private sector for workers by work hours and union status. Full-time workers are much more likely to have paid sick days than part-time workers (88% versus 56%). Unionized workers have greater access to paid sick days than nonunion workers (86% versus 80%).

Fortunately, there is a relatively simple way to address some of these inequities: The federal government can pass legislation to mandate paid sick leave for all workers. In the absence of federal action, state governments can move on their own and mandate that employers provide this key labor standard. Paid sick leave not only helps reduce the transmission of disease, it also provides economic security for workers who might otherwise lose income if they have to take time off from work.