Paid sick leave is gaining momentum across the country, with three more states, all traditionally Republican, passing ballot measures last Tuesday mandating the benefit.

“This type of law can pop up anywhere in the county,” said Josh Seidman, a partner in the labor and employment department at Seyfarth Shaw. “It isn't in just the states that are more pro-employee.”

The ballot measures all passed easily, garnering 57% support in Alaska, 58% in Missouri and 74% in Nebraska. The Alaska and Missouri measures also increased the minimum wage to $15 an hour.

The amount of paid sick leave mandated under the measures varied by employer size. Those in Alaska and Missouri with 15 or more workers, or those in Nebraska with 20 or more workers, must provide up to 56 hours of paid sick time annually.

When the last of the new measures kicks in next fall, 22 states will have paid sick leave or paid time off mandates, in addition to Washington, D.C., and more than two dozen municipalities, from Seattle to New York City. (Here’s a full rundown.)

San Francisco helped pioneer the movement, passing the first paid sick leave ordinance in 2007, and Connecticut became the first state to do so four years later. Public support surged following the COVID-19 pandemic, which laid bare the economic hardship that illness can cause for low-income workers and family caregivers, many of them women. The measures approved in Alaska, Missouri and Nebraska all permit workers to use their sick time to care for an ill family member.

According to the Bureau of Labor Statistics, 79% of private industry workers, 81% of civilian workers and 92% of state and local government workers have paid sick leave. But among the 25% of workers who earn the least, just 58% have paid sick leave, and among the lowest-earning 10%, just 40% do.

In addition to improving the economic footing of the nation’s lowest-paid workers, the mandates improve public health, advocates say. Research published last year in the American Journal of Industrial Medicine, based on 22 years of data, found that paid sick leave reduces occupational injury, the spread of contagious disease and “presenteeism,” where workers are on the clock but are ill and not fully engaged.

The measures do have opponents, including the National Federation of Independent Business, a small-business advocacy organization which argues that a “one-size-fits-all government mandate is both financially and administratively burdensome.”

Similarly, the Missouri Chamber of Commerce opposed that state’s ballot measure, writing that it “will always oppose new business mandates. We believe business owners know best how to run their own companies, and the government should stay out of the way.”

States are stepping in because of inaction at the federal level. While Congress during the COVID-19 crisis passed a temporary measure allowing parents of children whose schools were shuttered to take 12 weeks of sick leave at two-thirds pay, lawmakers have been unable to muster support for a permanent mandate.

That’s forced employers to comply with an ever-changing patchwork of mandates varying by state and sometimes even municipality. It’s not just a matter of tracking new mandates. Many states that previously approved mandates are adopting revisions. This year, for example, California, Connecticut, Massachusetts, Michigan and Minnesota amended their paid sick leave laws.

“Many multistate employers struggle,” Seidman said. There is a “constant drumbeat of change.”

Seidman expects the pace of change to continue to quicken.

“It’s really starting to spread itself to the entire country,” he said. “It’s really showing that this is a topic that seems to cross partisan divides. It is a benefit that enough constituents in Missouri and Alaska and Nebraska voted for it to pass. That’s a telling sign.”

Despite the bipartisan support, Seidman said he doubts a federal mandate will clear Congress in the near future. Gridlock on Capitol Hill in recent years has left the states to set their own regulatory frameworks on a broad range of matters, from privacy to artificial intelligence.

Shannon Meade, executive director of Littler Mendelson’s Workplace Policy Institute, the law firm’s government relations and public policy arm, sees a greater likelihood of state involvement. She said it will come down to where the issue falls among lawmakers’ priorities.

“I think it’s clear that Democrats and Republicans are looking to make meaningful headway on paid leave,” Meade said. “Is there going to be a political will to work on the national paid leave program? That’s an open question.”

In the meantime, labor and employment lawyers expect plenty of action on the state level, in part because the ballot measures passed last week raise the benefit bar. All three provide up to 56 hours of paid sick leave, compared with 40 in many other states.

“It is very likely this could lead to states that already have paid leave laws … to alter their benefits,” Seidman said.