State-Level Paid Sick Leave: Impacts of Policy Design on Access by Immigrant Workers

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ID: 328283
2026
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Abstract
Abstract Introduction Access to paid sick days (PSD) matters deeply to public health and workers’ economic security. State-level PSD laws have expanded rapidly, yet little is known about whether they are closing coverage gaps for immigrant workers, who are both overrepresented in public-facing jobs and disproportionately excluded from employer-provided PSD. Methods We built a state-level database of eligibility rules in all 15 states and DC with statewide PSD laws in effect as of 2024 and linked them to labor force data from the 2024 Current Population Survey Annual Social and Economic Supplement. We assessed how exclusions based on independent contractor status, firm size, minimum weekly hours, and annual work requirements shaped PSD coverage differences between citizens and non-citizens. Results Overall, coverage was lower among non-citizens than citizens (84.0% versus 86.9%, p<0.05). Significant disparities were identified in six jurisdictions, with the largest gap in Connecticut (49.3% versus 65.8%). Policy simulations showed that excluding independent contractors and small-firm employees were primary drivers of disparities. Removing these exclusions narrowed gaps and sometimes resulted in near-universal coverage. Conclusion Removing exclusions from state-level PSD policies would reduce inequities and increase access by immigrant workers, with benefits for all.
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Authors Zhenyi Luo, Aleta Sprague, Michael McCormack, Jody Heymann
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Journal Health Affairs Scholar
Year 2026
DOI
10.1093/haschl/qxag232
URL
https://academic.oup.com/healthaffairsscholar/advance-article-pdf/doi/10.1093/haschl/qxag232/71004941/qxag232.pdf
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