Even before COVID-19, turnover in the health care workforce was a concern. During the pandemic, the stress on health care workers, especially women, was profound. After COVID, substantial shares of workers reported burnout and said they were considering leaving the health care profession—and women were more likely than men to say they might find other work.

Now, the United States is in the midst of a health care workforce crisis, caused in part by the inability of nurses, physicians, and other caregivers to care for themselves and their families. The stability and quality of the health care sector, which is overwhelmingly comprised of women workers, and the country, depends on addressing this challenge.

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Direct care workers, like millions of other U.S. workers, also often have both children and older adults or loved ones with disabilities to care for. Yet they are extremely unlikely to have paid sick time or paid family and medical leaveunless they live in one of the minority of states that guarantees one or both of these policies. And even if they are in the right state, they may not get paid sick time or paid leave because of eligibility rules.

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