Followers may have noticed that I’ve taken a break from blogging. The rapid recovery I was experiencing after my fall in late November took a 180 degree turn such that I could barely sit due to the pain, let alone concentrate on policy issues.
Ultimately, I wound up back in a rehab facility and have only recently returned home. As I lay in bed there and now sit propped up in a pillow-cushioned chair, I find my thoughts riveted on our healthcare system.
One hardly needs fractured bones to worry about the fate of many millions of people who may no longer have affordable health insurance. I’ll have more to say about this.
But, for the time being, an insight that reaches beyond healthcare policy per se.
During both my brief stays in rehab, I raised concerns about how I would cope alone when deemed mobile enough to return home. The therapists, caseworkers and on-the-scene physician invariably responded with “Don’t you have family?”
Yes, as I suppose most patients do. But that doesn’t mean we have family members who can take on responsibilities for helping us with what the professionals call activities of daily living, e.g. bathing, dressing, cooking, housekeeping.
Lots of reasons that family members can’t become our primary caregivers. They may, for example, live so far away that they’d have to temporarily relocate. They may have children who need their daily care. They themselves may have health problems that limit what they can do.
Not much policymakers can do about these. But they can address one common barrier—potential lost wages or even jobs.
As you probably know, the federal Family and Medical Leave Act protects some workers from the latter. But it covers only about 60% of workers.
Laws in eleven states and the District of Columbia expand eligibility in various ways. But only five states and the District require employers to directly or indirectly compensate workers for any of the wages they lose when they take time off because of illness.
A handful of local governments have more expansive paid sick leave mandates than the state they’re in. But virtually all these laws exclude workers employed by small businesses—in some cases, very small, in others not.
The District also expressly excludes whole categories of workers, including all restaurant wait staff and bartenders who receive the subminimum tip credit wage.
In short, this safety net is a patchwork of protections that force hard, consequential choices between working for pay and caring for sick or disabled family members.
The District, however, is set to join the four states that enable workers to take time off for illness or other compelling reasons without forfeiting the income they need.
The DC Council recently approved a bill that would replace all but 10% of the wages that lower-income workers lose when they take time off to care for family members—not only those who are sick or disabled, but newborns and newly-adopted children.
It would also effectively supersede the paid sick leave exemption for most tip credit workers. And it would cover, at a lower replacement rate, all high-paid workers, as Rachel Sadon at DCist explains.
The bill caps the amount of paid leave workers can claim for each of the specified reasons, allowing up to eight weeks to care for their babies and/or develop a trusting relationship with a newly-adopted child.
Care for the likes of me would be capped at six weeks—a maximum the Council whittled down to add two weeks of personal medical care.
The bill adopts the paid leave model that California pioneered. Instead of requiring employers to pay their workers when they take time off for authorized reasons, it imposes a tiny payroll tax—0.62%.
The funds would go into a pool and then to workers entitled to replacement wages. So all District employers would collectively pay time off for all people who work in the District, except government employees.
The bill is the latest iteration of a proposal Councilmembers have worked on since 2015. It’s proved very controversial—and still is. “This [the final vote] is the battle, not the war, says a member of the DC Chamber of Commerce board.
The Mayor seems inclined to let the bill become law without her signature, thus indicating her disapproval without triggering a vote to override a veto. She clearly views the legislation as unfinished business, predicting the Council will have to revisit it before it becomes effective.
Translating the bill into a viable system would prove challenging, even if the administration wanted to make it work. One can only hope that it sets aside its reservations or comes up with a better solution.
I don’t know enough to know whether there is one. What I do know is that our healthcare system assumes a family caregiving role that our labor laws don’t accommodate.
The lack of paid time off leaves sick and disabled people vulnerable. My summary here indicates other compelling needs that may get short shrift.
But they often don’t because workers (mostly women) quit their jobs or shift to part-time work so they can fulfill family responsibilities.
This puts them at a disadvantage when they’re ready to return to the workforce or full-time employment. And it’s likely to disadvantage them when they’re ready to retire because the years when they earned nothing or very little often become part of the base for calculating Social Security benefits.
In the meantime, families whose breadwinners sacrifice to provide care have to make do with less or no earned income. This is a problem for all working families, but especially those dependent on a low-wage worker.
It’s also a problem for state and local governments because they must make do with less tax revenues and increased needs for safety net benefits.
Ideally, we would have a nationwide paid sick and family leave law. That’s obviously not in the cards during the next four years. So here’s another case where states and the District must do for their residents what Congress and the President won’t do for all Americans.