Introduction

No one should have to worry about losing their job for putting their family first during some of the most important moments in life. From the first moments of a child’s life to the last moments in the life of a loved one, we all need time to care for our families, and yet the United States is one of just six countries in the world that does not guarantee paid leave for workers. Although some workers are eligible for up to 12 weeks of unpaid, job-protected leave under the federal Family and Medical Leave Act (FMLA), just 39% of workers are eligible for and can afford to take six weeks of unpaid leave—workers of color, especially Hispanic immigrant workers, are the least likely to be able to access federal FMLA protections.

In the absence of federal action, lawmakers in 13 states and the District of Columbia have enacted legislation establishing a social insurance program that most workers can access to take paid family and medical leave (PFML) to recover from a serious illness, to bond with a new child, or to provide care to a family member with a serious illness.

Momentum for paid family and medical leave legislation has grown rapidly, with eight PFML campaigns celebrating success in the last five years. This publication summarizes some of the lessons learned by the legislative champions and advocates who led the way in ensuring that no one has to choose between caring for their loved ones and the paycheck that their family relies on.

The Basics of Paid Family and Medical Leave

PFML insurance programs vary from state to state but generally cover leave taken by workers for some combination of the following purposes:

• Medical leave to recover from a worker’s own serious illness;
• Bonding leave for parents to bond with a new child, including for foster and adoptive parents and those standing in loco parentis to a child;
• Caregiving leave to provide care for a family member with a serious illness;
• Military family leave to address needs arising from a family member’s military service; and
• Safe leave to address personal or family needs arising from domestic violence, sexual assault, or stalking.

In most states with PFML, workers are eligible for at least 12 weeks of benefits for covered purposes, often capped cumulatively for workers requiring multiple types of leave within the same year. Some of the earliest programs for paid leave were implemented by building on the infrastructure of an existing state temporary disability insurance (TDI) program. However, since only a handful of states had preexisting TDI programs, in most states, enacting a PFML law is only the beginning of a multi-year process of building administrative infrastructure, collecting payroll deductions, and conducting outreach to employers and employees before benefits can be distributed to workers. Typically, family leave costs are paid for by workers, while medical leave costs are shared between workers and employers.

Eligible workers apply for and receive a weekly benefit amount from the insurance pool that reflects a percentage of their average weekly wages. Most states utilize a progressive wage replacement calculation that ensures that lower-income workers receive a higher percentage of their wages, and in all states, benefits are capped at a maximum weekly rate that is adjusted annually. To ensure that all workers can access the benefits they are entitled to, PFML statutes also generally include provisions that protect workers from being fired or retaliated against by their employer for exercising their rights under the law. Critically, most states also give many workers the right to return to their job following a period of leave.

Click here for more information on the key elements of PFML policy.

Section 2: Campaign Strategy

Successful PFML campaigns are often part of a long-term and generative collaboration between lawmakers and advocates to improve the lives of workers in their communities, driven by years of intentional community organizing and thoughtful engagement with all stakeholders.

Preempting Progress: The Intersection of Democracy and Paid Leave

For many states, advancing PFML in the legislature may be a distant reality that will require long-term organizing and investments over many years. In these states, advocates may wish to consider focusing on state employee paid leave campaigns first. Campaigns to pass statewide or local paid sick leave for short-term medical needs, including preventive care, could be another option. 

However, lawmakers in 23 states have enacted laws prohibiting localities from passing their own paid leave laws. Across the country, state lawmakers have increasingly wielded abusive preemption laws to take power away from people and local communities in ways that disproportionately harm Black workers, women, and low-income workers. In addition to statewide PFML for government employees and repealing anti-worker state preemption laws, community benefit agreements (CBAs) for public works projects with paid leave requirements for government contractors may be another window of opportunity in these circumstances.

For more resources on preemption, check out the Local Solutions Support Center’s resources.

Building a Long-Term Plan

In many states, the passage of PFML legislation was just one piece of a multi-year and multi-issue vision for a care system and economy that works for all of us won by building power with communities historically marginalized by public policy. “This was work that had been going on well before I even thought about running for office—lots of work and lots of different people are part of this chain that got us to this point of getting paid family and medical leave across the finish line this session,” said Minnesota State Representative Ruth Richardson. “One of the very first conversations that I had with members of the coalition was to ensure that we were going to focus on ensuring those who have so often been left out of the safety net were centered within the work. Getting the bill passed, that’s just the first step. And there’s all of this work that needs to happen so that there really truly is equitable access for folks who have historically been left out of this conversation,” Rep. Richardson added.

Paid leave champions often utilize the formal structure and gravitas of a legislative process to work through the complex details of the program alongside stakeholders over the course of several years. Work to develop legislative buy-in began in 2001 when Maine lawmakers established a legislative study committee. Two decades later, Maine State Senator Mattie Daughtry and State Representative Kristen Cloutier co-chaired the legislature’s Commission to Develop a Paid Family and Medical Leave Benefits Program for three years before the bill finally passed in 2023. “We started every commission meeting with public comment,” said Sen. Daughtry. “So a lot of the people who were very opposed or very excited about it already had spent three years going through the process with us. They saw their comments get run in simulation models, and we always did our work out in the open.”

The Time to Care Oregon coalition worked alongside lawmakers to advance policy campaigns that built upon each other. “Paid family and medical leave was actually the second policy in a series of policies that we’ve been working on,” said Courtney Veronneau, Senior Political Director at Family Forward Oregon. “It started when we built the campaign and coalition to pass paid sick days in 2015. Then we used that win—that momentum and foundation—to build toward paid family and medical leave.” The same year that Oregon lawmakers finally enacted PFML in 2019, they also established the Task Force on Access to Quality Affordable Child Care. Just three years later, the coalition won a historic $100 million investment in child care informed by the recommendations of the task force. “Because we really nailed the coalition building and the values and principle setting process, partners knew that we were going to build an effective coalition that was really based in our values and principles and would have good power-sharing practices,” Veronneau added.

Community Organizing and Outreach

For many legislators and advocates, the wide-reaching scope of a new social insurance program meant that gathering public input early and often was critical to the success of PFML campaigns. “It’s hard for the average person to be able to make it to their state capitol,” said Maine State Senator Mattie Daughtry. “So we went out on tour. We asked people what they thought and got their feedback. By the time the bill hit the news, people had some sort of experience talking to us or looking into the policy. It made a better piece of legislation. And I think it smooths what is a very rocky road for a bill like it to pass anywhere.”

“People are really not used to being asked for input on legislation. And not only are they not used to being asked, but they’re not used to somebody coming to their community to ask that question,” added Maine State Representative Kristen Cloutier. “I think our genuine interest really helped to bring the temperature down a bit in a lot of contentious spaces.”

Similarly, legislators and advocates in Delaware took to the road to bring discussions about PFML to communities. “Once we had a bill and were kind of pushing for it, we did a three-county tour, where we brought a variety of stakeholders to basically have roundtable discussions on it,” said Delaware Cares Director Liz Richards. “It was a really great mechanism to learn, but also to organize and create a shared sense of mission and investment. The legislative sponsors were key to that. That was another way to build champions, like giving folks a platform to share their stories, share their support, and get more invested in the issue.”

For Maryland State Senator Antonio Hayes, the fight for paid leave was about centering the workers who need paid leave. “My advice to my legislator colleagues is: this is an issue that touches families in a way that’s immeasurable. And so, oftentimes, I would allow the space for the affected families to really take the lead and give their testimony as to why this is important to them,” said Sen. Hayes. 

At the same time, the bill’s passage was deeply personal to Maryland State Senator Antonio Hayes: “At a very early age, my grandmother was my caregiver. Fast forward to today, I’ve shared the responsibility of caregiving for my grandmother, which often called for me to step away from work at times to take care of her. In February 2022, I took a week off to spend time with my newborn son, but then I came back to work to make sure this bill got passed. I had to get back to make sure that other families had that opportunity—if they were having a child, that they could actually step away from work and not suffer the consequences of not being compensated by their employer.”

Engaging with the Opposition

Legislators and advocates approached their engagement with opponents, particularly corporate business interests, with an open mind, often over the course of years in ways that smoothed final negotiations ahead of bill passage. “We never said ‘no’ to any request to meet,” said Maine State Representative Kristen Cloutier. “You still learn from meetings with opponents. When people see that you’re willing to be uncomfortable in order to listen, it builds trust in the process.”

As a small business owner, Maine State Senator Mattie Daughtry deeply understood the concerns of many business interests about PFML legislation. “I’ve seen firsthand as an employer not only the cost of keeping your doors open, but also how the best investment you have is in your employees, and I’ve actually lost employees because we weren’t able to provide this type of benefit,” said Sen. Daughtry. “For any large policy, when you really take the time to sit with someone who’s opposed to it, you might not entirely win them over, but they’re going to leave the conversation knowing that you listened.” 

Paid leave champions also frequently note that opposition often comes from a place of misunderstanding about how PFML programs function as an insurance program and can benefit business owners. “Myself and other co-authors would have one-on-one conversations with people who are on the fence or were opposed to it,” said Minnesota State Senator Alice Mann. “But really, a lot of people that were on the fence or were opposed to it didn’t understand what the program was. We talked one-on-one with almost every single person in the legislature to educate them about the incredible, undeniable benefits of paid family and medical leave. And we did the same thing with business communities. We would talk to them, or we would ask business owners to reach out to other business owners to go over the benefits that businesses incur when they participate in the program.”

In Minnesota, these discussions resulted in provisions enacted into law designed to address small business owners’ concerns without excluding their employees, including premium reductions for small businesses and a grant program for temporary workers. “We ended up working out a space for businesses with less than 30 employees,” said Minnesota State Representative Ruth Richardson. “We really tried to be thoughtful around how we were negotiating that support for small businesses.”

Section 3: Policy Design

Navigating policy design and the compromises that come out of negotiations that pave the way to passage is challenging in any legislative campaign; when it comes to a policy as complex as establishing and implementing a multimillion-dollar insurance fund, equitable access and solvency can hinge on just a few key decisions. 

Starting with a Vision

Both legislators and advocates describe the importance of finding alignment on key policy provisions and setting the expectation that some form of compromise will be necessary early on in the process. “You have to have a vision from the start of where you want this to end up, of how you want this program to look like,” said Minnesota State Senator Alice Mann. “That vision is a culmination of what you think is right, what the advocates think is right, and what will actually benefit people. So when you start crafting the bill, make sure that you have that vision in mind and always start above your vision.”

“With the coalition, in the early stages, we weren’t sure what the lines in the sand were for our partners,” said Maine State Representative Kristen Cloutier. “Getting to the point where we understood what the lines in the sand were for our partners, we understood what the lines in the sand were for ourselves, and knowing where we could give and where we needed to hold strong was really important.”

“You have to be really upfront that not everyone’s going to get something. It almost sort of felt like a headline that we’d walk into: everyone would get some wins; everyone would get some losses,” said Maine State Senator Mattie Daughtry. “And once you made it clear that it wasn't going to be ‘my way or the highway,’ I think that really helps. But really building that trust and having the people around you who can be those types of messengers who are not only involved in the policy but understand what the parameters are that have to be kept in check.”

Weighing Compromise

With a vision in hand at the outset, legislators and coalitions can begin to weigh where compromise would and would not be acceptable based on shared values and goals. “Inevitably, you will get to a point where you have to negotiate, and I think the big question is likely going to be, ‘Do we cover everyone for less time? Or do we cover less people for more time?’” said Courtney Veronneau, Senior Political Director at Family Forward Oregon. “Are you essentially cutting some people out of the program, like part-time workers or low-wage workers? For our coalition—and lawmakers felt the same way—we were all in agreement that we’re going to go with less time off, but we’re going to cover everybody. That’s something you need to figure out before; I think it does make those things a little bit easier when it comes, if you can figure out those types of negotiation bottom lines first. Think about building the foundation for the best possible program you can absolutely get that covers everyone, that gets them the most time that you can get them, and that is set up in a way that people can actually use it.”

Some common compromises, however, are not only counterproductive to ensuring that workers who can least afford to take paid leave will be able to access the new program but can even undermine the solvency of the insurance fund. “There is always going to be an appetite to make an exception,” said Maryland State Senator Antonio Hayes. “The key to paid family leave is to have as much participation as possible so the fund can be and remain solvent. We’ve seen many cases throughout the country in states that have allowed certain exemptions or allowed certain carve-outs where the fund did not generate enough to support itself as it should. The whole idea behind this is for this insurance policy to be self-sustaining, and you don’t want to compromise in a way that jeopardizes the fidelity of the program.”

A Cautionary Tale: Voluntary Paid Leave and Other Alternative Paid Leave Models

The comprehensive programs adopted in 13 states and the District of Columbia are designed to provide access to PFML to all workers, but in recent years, some states have adopted a narrower approach that continues to leave most workers without adequate access. New Hampshire lawmakers enacted legislation (2021 NH HB 2) to provide six weeks of paid family leave to public employees. Under the new law, private employers can voluntarily opt in to the program, and workers can choose to purchase their own paid family leave insurance. A similar approach was adopted through executive action in Vermont. 

Legislators in Virginia passed a bill (2022 VA SB 15), based on a model bill proposed by the insurance industry, to allow insurers to sell paid family leave insurance plans that meet certain requirements. Texas lawmakers recently enacted similar legislation (2023 TX HB 1996). This approach provides no guaranteed right to PFML for workers and is billed as a private market solution. However, the private market has not met the incredible demand for PFML nationwide. Moreover, legislation authorizing private insurers to offer voluntary paid family leave insurance policies to employers may not be legally necessary in some states.

Paid leave champions should approach both models with some caution. New Hampshire officials recently announced that only 1% of employers have signed up for the voluntary program, while only 644 individual workers have purchased the insurance. Meanwhile, only one insurer has sought and received approval to offer paid family leave insurance in Virginia.

Building Collaboration into Negotiations

The Time to Care Oregon coalition would assemble its negotiating team based on which organizations would provide the necessary policy expertise and the power and influence to succeed in the room. “When it came to negotiations where we needed an even smaller set of folks, essentially we were able to then collaborate as a team to strategize heading into negotiations,” said Courtney Veronneau, Senior Political Director at Family Forward Oregon. “We would always have conversations with our legislative champions beforehand; we were always trying to work as much as we could to get on the same page as much as we could. We saw ourselves as having different roles, but when we were headed into that room, we were like part of a team.”

Long before it came to negotiations, the Time to Care Coalition also agreed to an inclusive process for decision-making on key policy provisions. “If there was ever a policy negotiation on a piece that directly impacted a constituency that was not represented in the room but was part of our coalition, we all had a very firm line and an agreement that whoever was in that room was not going to agree to anything before being able to go back and have conversations with that particular constituency,” said Courtney Veronneau, Senior Political Director at Family Forward Oregon.

This process was recently tested during the 2023 legislative session when lawmakers were considering legislation to amend the state’s PFML program, including expanding the definition of “family member” under the program. “The business lobby wanted to specify what ‘affinity’ meant, and there was a discussion on whether we wanted to specify that in statute or rules, and immediately we wanted Basic Rights Oregon to know about this and weigh in on definitions and what kind of language would be best,” said Lisa Kwon, Policy Manager at Family Forward Oregon.

When it came time for policy negotiations in Delaware, legislators continued to communicate developments with community members. “The willingness, the exercise of listening and continuing to have an open line of honest communication, which I think Delaware State Senator Sarah McBride did extremely well, even in communicating tough choices,” said Delaware Cares Director Liz Richards. “Continuing to talk to people, including the most impacted people, is critical, and frankly, remembering them when they’re not there because they can’t be there. More often than not, low-wage workers don’t have time or aren’t even invited into the room. It’s really, really hard work to advocate and go to powerful people and beg for things that are owed to you—that takes a lot. Legislators are sent there to fight for the people who aren’t in the room.”