• Voters in three solidly red states, Alaska, Missouri and Nebraska, backed ballot measures on paid sick leave, showing how some issues historically associated with progressive policy circles have developed core support among working-class voters.
• Bernie Sanders lambasted the Democratic Party after a night on which it suffered significant losses for not understanding the "pain and political alienation" among millions of voters, and cited paid family and medical leave among other issues.
• National momentum is building for this labor policy, which has both Democratic and Republican support. In Trump's first presidency, Ivanka Trump was a strong proponent of a federal paid family leave program.

For some workers, the decision to stay home when sneezing and coughing will no longer mean forgoing a day's pay. 

In Tuesday's election, ballot measures passed in three red states — Alaska, Missouri and Nebraska — that would require employers to provide earned paid sick leave for employees, with certain exceptions. 

This follows a similar trend in states across the U.S. — though to date in mostly liberal-leaning states —that have already passed laws requiring private employers to provide some form of paid sick leave to eligible employees. More than two dozen municipalities across the U.S. have adopted similar provisions. 

The issue has a long history of support from the progressive wing in U.S. politics. In fact, in a scathing statement on Democratic losses in the election, Vermont's independent Senator Bernie Sanders specifically cited paid family and medical leave among the issues where Democrats had failed to capitalize on issues that reach millions of voters who feel "pain and political alienation."

One of the key takeaways from these election results was that the votes of more working-class Americans are up for grabs and core economic and worker issues resonated.

Minimum wage increases also passed in Alaska and Missouri.

The Economic Policy Institute, a progressive think tank, noted in an election recap: "Voters given the opportunity to weigh in directly on questions of economic justice showed policy preferences far more progressive than those reflected in many national and state election outcomes."

"I would not be surprised to see more states move in this direction," said Tom Spiggle, an employment law attorney and founder of the Spiggle Law Firm about momentum for paid sick leave laws.

Here's what workers need to know about the changing landscape:

There is no federal requirement for paid sick leave

On the federal level, the Family and Medical Leave Act entitles eligible employees to take up to 12 weeks per year of unpaid, job-protected leave for specified family and medical reasons. However, no federal law generally requires private employers to provide paid leave to employees needing time off to care for their own medical needs or a family member's.

That's where state laws come in. The sick leave policies that states and municipalities have enacted are meant to allow workers to recover from an illness or care for a sick family member — for a short time. Missouri's new law, for example, says that employers with 15 or more employees may limit an employee's use of paid sick leave to 56 hours per year. Businesses with fewer than 15 employees may impose a 40-hour per year limit.

State-based paid sick leave policies aren't meant for a very ill family member who is going to require round-the-clock care; they are generally for one-off times when you are sick or have to take someone to the doctor, said Jill Kahn Marshall, partner at Reavis Page Jump.

State and local requirements on use of paid sick time off vary

Caroline Donelan, partner at Blank Rome, said paid sick time laws are different across states and municipalities in ways such as accruals, carryover days and permitted uses of the paid time off, which can make it challenging for employers and employees.

While most policies can be used for an employee's illness or an employee's family member, how a family member is defined can differ by location and state, Donelan said. In some states, you can use it for purposes beyond sickness. In Colorado, for instance, workers could use their paid sick leave if a child's school is closed due to inclement weather, she said.

Many paid sick leave laws also include "safe time" or "safe leave" provisions, according to HR and payroll firm Paycor. These provide paid sick leave benefits to workers impacted by domestic violence, sexual assault or stalking. Employees may be permitted to use their days for medical care, or to attend court proceedings, move, or go to counseling appointments, for example.

"It's another area where employers are facing multiple local and state requirements. For better or for worse, it seems like the federal government is continuing to let this be a state issue," Donelan said.

Private employers may have more generous policies

Some of the measures that require employers to offer employees paid sick time off have their roots in the pandemic, during which the federal government passed an emergency measure to allow people to take paid time off, Kahn Marshall said. 

While states have taken up the issue, many private employees have even more generous sick leave policies. Since the pandemic there has been a "more general recognition that people get sick and their family members get sick and they deserve to be paid under those circumstances, up to a reasonable point," she said.

Momentum for a federal law could come from the states

More states are taking up these measures because of the understanding that "healthy, happy employees are good for the bottom line," said Robert B. Hinckley Jr., a shareholder in the law firm Buchalter. But it's possible the federal government could decide to swoop in for more uniformity.

There has been legislation floated that calls for a federal policy on paid sick time off, which could have value for companies that operate in multiple states. Thus far, however, it hasn't advanced. "It could create a consistency that could be helpful for employees and employers," Hinckley said.

"There is political momentum at the state level. The question is does that create momentum for a federal law? Oftentimes, federal laws follow; they don't lead."

States with mandatory paid sick leave

• Arizona
• California
• Colorado
• Connecticut
• Illinois
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Nevada
• New Jersey
• New Mexico
• New York
• Oregon
• Rhode Island
• Vermont
• Washington
  Source: Paycor
  (Note: In addition to many cities around the U.S., Washington, D.C., though not a state, also has a paid sick leave policy comparable to many states.)

What's next for employees in states with new laws

People who live in states where laws on paid sick time are changing due to ballot initiatives should ask their employers how and if the new laws apply to them. There are restrictions, for example, for certain types and sizes of businesses. Generally speaking, people who are eligible for paid sick time off should exhaust their state or employer's private sick paid leave first. If they require more days, they might be eligible for unpaid leave under FMLA, Kahn Marshall said.

Employees who need to use more sick days than they are paid for should talk to their employer about what the options may be for unpaid time off. 

Other types of paid leave policies

To be sure, some states also have other types of paid leave policies, such as paid family leave. Generally, those policies are meant to cover longer periods. 

New York, for example, offers certain workers 12 weeks of paid time off under its family leave policy. Starting on Jan. 1, pregnant workers in New York may also have additional paid time off available to them for doctors' appointments, procedures or other prenatal care.

These types of policies are also state-specific. As of the end of August, 13 states and the District of Columbia had enacted mandatory paid family leave systems, according to the Bipartisan Policy Center, a not-for-profit organization that helps policymakers craft bipartisan solutions. An additional nine states have voluntary systems that provide paid family leave through private insurance, Bipartisan Policy Center data show. 

This, too, could be an issue that's taken up by the incoming administration. In Trump's first presidency, Ivanka Trump was a strong proponent of a federal paid family leave program. "It is a popular program both within Republican and Democratic circles," Spiggle said.

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