The United States is the rare developed country that doesn’t guarantee any paid leave for its residents. For Joe Pierpont and Janet Peck, that has meant major disruptions to their work and income when their children, extended family, or they themselves get sick or need care. Pierpont has worked at a Maaco auto shop in Delaware for five years, but he’s never received paid leave other than a few weeks of vacation time. “They really don’t care about people,” he said of his employer. When something minor comes up, like one of their two kids getting sick, his partner, Janet Peck, who currently doesn’t have a paid job, typically deals with it alone.

But the family has faced a series of emergencies that have been harder to absorb. Right before the pandemic, their youngest child got an infection that landed her in the hospital for a week. Pierpont couldn’t take any time off from work, so he took care of their older son and shuttled clothes and food to Peck at the hospital 20 minutes away. She more or less lived at the hospital with her daughter. Had Pierpont been able to take a few days off, the couple could have swapped roles so Peck could go home to sleep and shower. When Peck gave birth to her daughter five years ago, she was able to take only unpaid leave from her assistant manager job at a McDonald’s. A few years ago, Peck went to the hospital for a panniculectomy to remove excess skin after gastric bypass surgery. It was supposed to be a one-night hospital stay. Instead, after she lost a “scary” amount of blood, she ended up staying for five nights. To care for their children, who are both autistic, Pierpont took a few days off without pay and then had to ask his mother and a friend who also has special-needs children to help him.

The lost income meant a financial hit. When Peck was hospitalized, “at least it was only a couple of days,” she said. “Had it been longer than that, we would have been really hurting.” She still hasn’t paid off those medical bills.

When older relatives have gotten sick, Pierpont and Peck haven’t been able to be with them. In 2012, Peck’s mother, who was living with them, was gravely ill with lung cancer. Neither Peck nor Pierpont had paid time off, so in her final days they still had to go to work instead of being with her. A few years later, Peck’s father, who also had lung cancer, ended up in the hospital and wasn’t expected to recover. Peck had just started working in a school cafeteria a few months before and had accrued barely any paid leave. When she traveled to West Virginia to see him, and then again a few months later when he passed away, the days off cost her her job. A little over a year ago, when Pierpont lost his grandfather, who “was a very important person in my life,” he said, he couldn’t take any time off to be with his family.

“You go to work sick because you have no choice,” Peck explained. “You got bills to pay, kids to take care of. You got things you have to do.”

Peck and Pierpont aren’t alone. A quarter of private-sector workers don’t get paid sick leave from work, while just one in five gets paid family leave for the arrival of a new child or a serious illness or injury. The only federal program, the Family and Medical Leave Act, provides 12 weeks of unpaid time off.

That changed last spring when the pandemic began. One of Congress’s very first responses to the crisis was the Families First Coronavirus Response Act, passed in March 2020, which included a mandate that certain employers had to provide their workers with two weeks of paid sick leave at their full wages to quarantine or recover from Covid-19, and up to 12 weeks of paid leave to care for children whose school or day care had pandemic-related closures at two-thirds of their pay. It was the first time that the federal government mandated paid leave.

For the first time, Pierpont qualified for paid leave from work. And he needed it. Peck was overwhelmed by assisting both children, ages 16 and 5, with getting set up with remote school. Both needed one-on-one attention in those early days. “I can’t split myself into two people,” Peck said. She wrote a letter for Pierpont to take to work, complete with all of the reasons he qualified for Families First paid leave. “It wasn’t well received,” Pierpont said with a laugh. “They thought I was lying, and just thought I wanted to leave, that was the feeling I got.” But his employer couldn’t refuse. The law required covered employers—those with fewer than 500 employees but more than 50—to let their employees take the time off.

Pierpont took 10 weeks off. It was “really helpful,” Peck said. It gave them time to get a laptop from school and set up that and a tablet for their other child—a big challenge for Peck, who up until recently had a flip phone and still doesn’t like to use apps. With one parent focused on one child each, they were able to set up their older child to work largely independently so Peck can help her younger daughter.

“For the people who [Families First leave] reached, it was a lifeline,” said Dawn Huckelbridge, director of Paid Leave for All.

It took a once-in-a-generation catastrophe to get there. Before the pandemic, many people “thought of paid leave as only about babies,” said Ellen Bravo, founder and strategic adviser for Family Values @ Work. But the pandemic made it crystal clear that paid leave is also crucial when it comes to illness—one’s own, or one’s family member’s. Years ago, Bravo was campaigning for a paid sick days ballot initiative outside of a restaurant in Milwaukee when someone responded that he already had paid sick days. “I said, ‘Great, how about the person who made your lunch?’” she recalled. “He wheeled around and said, ‘Where do I sign?’” The pandemic has made this realization acute for the entire country: When some Americans don’t have paid sick days, they can put everyone’s health at risk.

Local paid leave campaigns like the one in Milwaukee had laid a foundation long before the pandemic hit. Today, 13 states and Washington, D.C., plus another 19 cities and three counties, have enacted their own sick leave guarantees. Nine states and Washington, D.C., have paid family leave programs. When Covid-19 started rampaging across the country, “Congress realized they had to act,” Bravo said. “That was a result of our movement, years of years of struggle and victories.”

Lawmakers acted with urgency. “From the outset, policy-makers agreed in a bipartisan fashion that paid sick and family leave was a necessary component of addressing the public health crisis and the care crisis,” said Vicki Shabo, senior fellow for paid leave policy and strategy at the New America foundation. It was a notable shift. “When a crisis hits, this isn’t a political issue—this isn’t a partisan issue,” Huckelbridge said. “That in itself shows there was a clear recognition that this was a hole in our system.”

It also helped the public recognize the same thing. “It’s on the agenda in a way that it wasn’t before,” Shabo said. “The taste of this has created a new awareness that this is something government can do.”

Families First paid leave saved lives. One study found that the sick leave reduced cases by around 400 a day.

But it could have done more good had it been a stronger policy. Despite support for the policy among Republican lawmakers, then–Secretary of Labor Eugene Scalia expanded a carve-out for health care workers to such an extent that virtually none could qualify. He also excluded more small businesses than in the original legislation. A judge later ruled both exclusions illegal. The agency’s inspector general also later found the agency did little to enforce compliance and didn’t do enough outreach to eligible workers. In the end, the carve-outs meant an estimated 106 million workers weren’t able to use the paid leave.

Peck and Pierpont are grateful for the paid leave. “If Janet had been completely by herself without any help, it would have been too much,” Pierpont said. Still, taking the time off work didn’t come without hardship. The law only guaranteed two-thirds of his pay. Peck pointed out that they’re “not extravagant people”—they don’t eat out and they cut their kids’ hair themselves. Still, “when he only gets two-thirds of his pay, I have to budget even harder,” she said. She applied for food stamps and sought out food assistance from a charity for the winter.

Families First paid leave “shows the value” of paid leave, Bravo noted, but also “shows it has to be inclusive and it has to be effective.”

What little mandated paid leave we had is now gone. Congress didn’t reinstitute the program in the relief bill it passed at the end of last year, nixing the mandate and only preserving the tax credits that help businesses offset the cost of leave if they want to offer it. The credits could act as an incentive to keep providing benefits to employees who may now expect them, or for employers who want to provide leave and can’t afford it otherwise. But their impact is likely limited. “If voluntary action were enough we would already have paid sick days for everyone and paid family and medical leave,” Bravo said. Many small-business owners still can’t afford it. Larger ones simply refuse.

Marjorie Wolfe, who owns the engineering firm Wolfe Water Resources in Oregon, knows she has to offer competitive benefits to attract the talent she needs for her business. She’s found a way to offer health care, a 401K, and three weeks of paid time off that can be used for any purpose, but hasn’t been able to offer longer time off for family leave. “Financially, it takes a lot to set this stuff up,” she said. And as a government contractor, any increase in her costs, and therefore her price, risks her bids’ getting undercut by other companies that don’t offer comparable benefits. When an employee became a new dad last year, he took time off by saving up PTO.

Although all of her employees were easily able to work from home when the pandemic shut everything down, the parents needed some kind of relief. They were struggling to put in a productive 40 hours a week with their children at home. But Wolfe didn’t have the resources to offer paid leave on her own. “We weren’t in a position where we could just willy-nilly pay people when they weren’t working,” she said, particularly because her company bills for employee work hours. “If they’re not working, then it drains the bank account really fast.” She also feared setting up a paid family leave program she wouldn’t be able to afford to keep running after the pandemic.

She turned to Families First, which gave her the financial room to allow employees to take the sporadic time off they needed to juggle everything. Of her 20 employees, three made use of the new leave. “That helped them show up to work in a better way,” she said.

Ultimately, Wolfe is eager to see a permanent paid leave program. Her state will begin one in January 2023, but she wants a national solution. “Government needs to lead,” she said. It would allow her “to support our employees in what they need in a way that doesn’t put us at a competitive disadvantage.”

Advocates say this is a critical moment to push paid-leave legislation. President Biden has promised to include paid family leave, which would offer paid time off for a new child, a serious injury or illness, or to care for a disabled family member, in the second half of his infrastructure legislative package. “We have an administration that’s committed to it, and we have a lot of champions who are determined and we have a movement that’s more widespread, more coordinated and ready than ever,” Bravo said. Recent history suggests the effort could be bipartisan: A number of Republicans touted their votes for Families First paid leave after it passed. Senator Chuck Grassley put out a press release saying, “In this package, we increase both paid sick leave and paid family leave to ensure people can stay home to stop the spread of coronavirus.” Bravo noted that many paid family and sick leave bills at the city and state level have passed with bipartisan support, and it’s an issue that voters of both parties overwhelmingly support. Even the Chamber of Commerce supported Families First paid leave.

“We hope we’ll convince a bipartisan majority,” Bravo said. “But we’ll find a way even if we can’t.” If Democrats can’t secure Republican votes, they could pass paid family leave through budget reconciliation, an arcane Senate process that bypasses a filibuster and allows budget-related legislation to pass on a simple majority. It’s an option that all of the advocates I spoke to believe is permissible under Senate rules. What’s imperative is that it gets through. “When this is all over, no one’s going to remember how it got passed,” Bravo noted. “They’re just going to ask, ‘Can I pay my bills, can I take care of my children and family?’”

“We certainly feel that now is the moment, and we’re organizing for the moment.” Shabo said. “If we get to the end of this period of time and we have not taken action to guarantee access to paid leave benefits to workers, we will have missed a real opportunity, and that will be a tragedy.”

For Peck and Pierpont, paid family leave would be a vital first step in protecting their ability to care for their themselves and their families. If there were federal paid leave policies guaranteeing all workers paid sick days and paid family leave, “then we’d have peace of mind,” Peck said. “We really could have used that many, many times.”