Absence of conflict of interest.
Highlights
- The study's objective was to examine the impact of paid family leave (PFL) on employment for individuals whose spouses had a medical condition or limitation and experienced health shocks. The authors investigated similar research questions for parents whose children experienced health shocks, the profile of which can be found here.
- The authors used a difference-in-differences design to estimate the impacts of PFL on employment for individuals whose spouses had a medical condition or limitation and experienced health shocks, using data from the Medical Expenditure Panel Survey. They used a statistical model to compare changes in employment before and after PFL was introduced, in states that implemented PFL policies versus those that did not.
- The study found that for individuals whose spouses had a medical condition or limitation and experienced health shocks, the availability of PFL reduced the likelihood that the individual left their job to care for their home or family. This finding was statistically significant.
- The quality of causal evidence presented in this report is moderate because it was based on a well-implemented non-experimental design. This means we are somewhat confident that the estimated effects are attributable to paid family leave, but other factors might also have contributed.
Intervention Examined
Features of the Intervention
While the United States lacks a federal paid family leave policy, the 1993 Family and Medical Leave Act provides twelve weeks of unpaid leave for new parents. In 2004, California became the first state to implement a paid family leave policy, offering six weeks of leave with partial wage replacement for new parents. By 2022, ten additional states had enacted paid family leave policies.
This study examined the impacts of paid family leave policies in California, New Jersey, and New York, implemented in 2004, 2009, and 2018, respectively. These states’ policies share similar eligibility requirements and provide partial wage replacement for parents of newborn or newly adopted children and those caring for ill family members. However, they differ significantly in other key areas including statutory leave duration, wage replacement rates, maximum weekly benefit amounts, and the availability of job protection.
Features of the Study
The authors used a difference-in-differences design to estimate the impacts of PFL on employment for individuals whose spouses had a medical condition or limitation and experienced health shocks. They used data from the Medical Expenditure Panel Survey. This restricted-use dataset from the Agency for Healthcare Research and Quality included data on the state of residence, demographics, socioeconomic characteristics, medical conditions, and labor market outcomes for every family member in a household collected in five rounds of interviews over a two-year panel. The authors pooled data from 1996 to 2019 and restricted the study sample to 2,735 employed individuals aged 25 to 64 whose spouses reported having at least one medical condition or physical or cognitive limitation and experienced a health shock during the study period. Of these, 237 had access to PFL, while 2,498 did. The average age of the sample was 48, with an average of 0.7 children under 18. Demographically, 52 percent were male, 17 percent were Hispanic, 12 percent were Black, 5 percent were Asian, and 65 percent were White. Half of the participants had 12 or fewer years of education, while the other half had 13 or more years.
The treatment group included individuals whose spouses had a medical condition or limitation and experienced health shocks and who lived in CA, NY, and NJ, where they had access to PFL during the study period. PFL provided partial wage replacement to individuals whose spouses had a medical condition or limitation and experienced health shocks. The comparison group included individuals whose spouses had a medical condition or limitation and experienced health shocks and who lived in all other states (except Rhode Island), where they did not have access to PFL during the study period. The authors used a statistical model to compare changes in employment before and after PFL was introduced, in states that implemented PFL policies versus those that did not.
Findings
Employment.
- For individuals whose spouses had a medical condition or limitation and experienced health shocks, the study found a statistically significant 5.1 percentage point decrease in the likelihood of leaving a job to care for the home or family.
- For individuals whose spouses had a medical condition or limitation and experienced health shocks, the study did not find statistically significant impacts of PFL on the likelihood of leaving a job for other reasons.
- For individuals whose spouses had a medical condition or limitation and experienced health shocks, the study did not find statistically significant impacts of PFL on the likelihood of employment.
Considerations for Interpreting the Findings
The authors generated impact estimates using advanced methods designed to address variations in treatment timing across states and potential deviations from parallel pre-treatment trends. These methods helped adjust for potential violations of the parallel trends assumption. The authors also generated estimates using conventional difference-in-differences methods. For some outcomes, findings were sensitive to the statistical method used to generate impact estimates. This profile only summarizes findings estimated using the advanced methods that more rigorously addressed potential violations of the parallel trends assumption and that were thus eligible for a moderate causal evidence rating.
Causal Evidence Rating
Research Guidelines
Review Protocol: Living Systematic Annual Search and Review Protocol
Review Guidelines: Causal Evidence Guidelines