The United States is one of the only rich countries not requiring employers to give their workers paid time off when they’re sick. It has become an urgent issue for more Americans because of the coronavirus outbreak.

Citing the crisis, Democrats in Congress are trying to pass a new version of a sick leave bill that has been stalled in Congress since 2004 — and expand it to add 14 days of immediately accessible paid sick leave in the case of a public health emergency.

An economics study released Monday offers an idea of what might happen if the bill passed. It’s the biggest study of the effects of state sick leave laws in the United States. In states that mandated sick leave, it found, fewer employees worked when sick. On average, they took two additional sick days a year. And the cost to employers who began offering sick leave after the laws passed was relatively small.

“Right now, the experts are telling people: Stay home if you’re sick,” said Sen. Patty Murray, a Democrat from Washington and a sponsor of the new bill.

But many workers, including those in the service industry, cannot follow the advice without losing a paycheck, she said.

“That’s why paid sick days are such a critical part of this response,” Murray said.

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Republicans have generally not supported a paid sick leave mandate, but Monday night, President Donald Trump said he would be meeting with congressional leaders to discuss relief for workers. Officials said the ideas include a payroll tax cut, small business loans and legislation intended to protect hourly wage earners who may have to miss work because of the spread of the virus.

U.S. workers have unequal access to paid sick leave. One in four workers has no access, according to Labor Department data. That includes 6% of the highest earners and two-thirds of the lowest earners. Forty percent of workers in service jobs, like those in restaurants, shops or child care centers, have no paid sick time.

Murray and Rep. Rosa DeLauro, D-Conn., are sponsors of a bill that would enable workers to accrue up to seven days of sick time. In response to the coronavirus outbreak, they introduced a bill that would also require that employers of any size offer paid sick leave (previously it was only those with 15 or more employees), and that they give an additional 14 days in a public health emergency.

In Washington state, the state’s unemployment insurance program will cover workers whose companies close due to the outbreak, Nick Demerice, spokesperson for the state employment security department, said in early March. Likewise, workers who require hospitalization or who must take care of a stricken family member may be covered under the state’s Paid Family and Medical Leave law, which went into effect this year, Demerice said.

Whether employees who are quarantined would qualify for the law is unclear, Demerice said.

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On Sunday, the Democratic leaders in Congress, Nancy Pelosi and Chuck Schumer, called for a range of health measures, including paid sick leave for workers under quarantine or whose children were out of school because of coronavirus.

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Under the bill, employers would be responsible for paying for the sick time; there would be no tax increase. Other policymakers have said they were considering assistance, like loans or grants, for small businesses coping with employees and customers staying home during the outbreak.

In the new study of the effects of sick leave, researchers analyzed what happened in five states and Washington, D.C., before and after they passed sick leave laws, and compared this with states that didn’t pass laws. They used data on 400,000 employees from 2009 to 2017, from the Labor Department’s National Compensation Survey, which tracks wages and benefits reported by employers. (Previous studies have generally relied on surveys of employees about whether they took it.)

On average, employees in states that passed sick leave took two more sick days a year, or 16 hours of sick time. Eight in 10 employers offered it after the laws took effect, an increase of 20% (some did not comply with the law.) The average cost to employers that started offering it was 20 cents per hour worked.

The study, published as a working paper by the National Bureau of Economic Research, also found that paid sick leave laws didn’t reduce employment or wage growth, and didn’t have unintended consequences of reducing other benefits, like vacation time or disability pay.

The researchers used a standard economic model to try to assess how the policy affected employers’ and workers’ well-being: things like health, income and profit. They determined that workers were healthier and better off. Employers might benefit in other ways they couldn’t measure, they said, like improved productivity and morale among employees, and a decreased chance of sickness spreading in the workplace.

“Maximizing profits can often lead to an outcome that is less than the best outcome for society,” said Johanna Catherine Maclean, an economist at Temple, who wrote the paper with Nicolas Ziebarth of Cornell and Stefan Pichler of the KOF Swiss Economic Institute. “We find that when we think about that collective well-being, society is better off after the mandates than before the mandates.”

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