Nationally, parental leave policies have become increasingly popular in part because they make it easier for women to attend doctor appointments and breastfeed, both of which are central goals for the Health Department’s strategic plan. 
Another department goal is to reduce deaths of Black babies, which occur three to five times as often as deaths of white babies. And disadvantaged mothers are more likely to actually go on leave when there is a policy that provides financial assistance while they are at home, researchers say.

The department’s leaders proposed a policy based largely on its health goals after doing a study that found only about two in five birth parents had access to paid leave. 
“We are the public health department,” said Dr. Iulia Vann, the department’s director. “What we want to have very tightly put together is the real public health implications of this policy before it goes to the Board of Health.”

While paid leave laws are structured in a variety of ways, the main tenets of the county’s proposal would be more generous than the policies enacted by 14 other states and Washington D.C. 

Most of these states offer 12 weeks of leave rather than 18 weeks. And these states typically pay around 70-90% of a parent’s wages and cap the total payout between about $900 per week in the least generous state, Delaware, and about $1,600 per week in the most generous state, Oregon. Allegheny County’s policy includes no specific cap.

Paid parental leave is mandated in more than 180 countries, including all 55 high-income countries besides the United States. About a quarter of all countries offer 18 weeks or more and more than half of all wealthy countries do.

The 12-week standard in the United States became established in 1993 as part of a political compromise. One of the most prominent Harvard doctors to testify at the time was recommending 18 weeks. The International Labour Organization, an agency that sets worker standards for the United Nations, recommends 18 weeks of leave. 

One of the biggest benefits of extending parental leave from 12 to 18 weeks, according to several researchers, is that it would provide additional time for mothers to breastfeed. “There’s a pretty strong correlation between returning to work and stopping breastfeeding,”  said Waldfogel, of Columbia. Breastfeeding can improve a baby’s immune system and reduce sickness through six months of age.

Most states that offer paid parental leave offer it for both parents as well as adopting parents – the same as Allegheny County has proposed. Some of these states offer additional health leave for new mothers. 

In some other countries, such as the United Kingdom, birthing mothers have traditionally received much longer leaves than the parent who didn’t give birth. Gayle Kaufman, a Davidson College sociology professor who studied its system, found that its policies disproportionately forced mothers out of the workplace. “Long term, that sets up a workplace where women are going to be judged based on whether they might have a child and whether they might take time off,” Kaufman said. (The UK now allows both parents to share their year of leave.)

More research has been done about the health and economic impact on mothers than on fathers, experts say. But there is some evidence that, in addition to improving how involved fathers are at home, having a second parent at home improves the mental health of the birth mother. 

“Having a father at home in the weeks after childbirth improves maternal postpartum mental health and she’s more able to seek care for physical health issues,” said Maya Rossin-Slater, a health professor at Stanford University.

Nearly every state that has passed a policy pays for it with a payroll tax that splits the burden across taxpayers. Allegheny County, however, doesn’t collect income tax. Instead, the county would require that businesses pay for leaves on their own.

A study of California’s paid leave program suggests that about two-thirds of the county’s businesses will have to pay the employee’s salary while they are on leave. The other third would also have to pay for a replacement.

There is a lot more research showing the health benefits of parental leave policies than there is research showing its economic impacts. “It’s harder to do this work with businesses,” said Stanford’s Rossin-Slater. “And so we just have less evidence.”

Washington, D.C., is the only jurisdiction where businesses shoulder all of the cost – by paying a 0.75% tax, which also covers personal and family medical leaves. 

Making businesses pay isn’t ideal, according to some international bodies. The International Labour Organization recommends paying for parental leave with social insurance or public funds, rather than directly requiring it from businesses, saying funding can “combat potential discrimination against women in the labor market.” 

Less than a quarter of the countries in the world require businesses to pay for parental leave directly, according to one study, and the impact of this approach is not well studied, according to Rossin-Slater. “There’s less evidence one way or another whether that’s a big burden.”

Most states have been able to cover the costs of their parental leave policies with a payroll tax of less than 1%. Since payroll costs make up only a portion of a business’ total revenue, many businesses would see their costs increase by less than 1%.

So an average business should expect its costs to rise by less than 1%, with variation based on the number of employees who go on leave and whether the company has to hire replacements. In the long term the costs are less clear: Several studies have shown that companies have to spend less on hiring new workers because employees with parental leave stay in their jobs longer.

Experts said there has been little evidence that parental leave policies have big economic consequences. Although the county proposal is more generous than what’s offered in some states, other countries have enacted more generous policies without major economic consequences. 

“I don’t think we can say that this is super burdensome for small businesses because I don’t think there’s good evidence of that,” said researcher Rossin-Slater. “From the evidence that we do have, it says it’s not.”

Some businesses will face little or no direct costs, because they will be able to shift their work assignments to cover their employees on leave. In states with leave policies where this has been studied, about two-thirds of businesses said they were able to shift work assignments without hiring a replacement.

Dirk Doebler, the founder of Parento, which sells private parental leave insurance, offers premiums based on the number of workers at a business, their salaries, the age and gender of employees and how much leave they offer. Allegheny County companies could buy private insurance to cap their annual parental leave costs, though the premiums could exceed what they would otherwise pay in years when few employees take leave. Businesses could then raise their prices or decrease their wages enough to offset the cost of the insurance. 

The county’s proposal does not provide an exemption for small businesses. But most states either provide a discount or exempt small businesses with fewer than 10 to 25 employees entirely.

Waldfogel, of Columbia, said that she and her colleagues sent surveys to businesses of all sizes in New York and Pennsylvania, both before and after New York’s paid leave policy went into effect. She found that employers in New York were able to manage absences just as well as those in Pennsylvania after the policy went into effect and employees performed just as well, if not better. This result is consistent with several other studies, she said.

“Regardless of what kind of policy exists, events happen and people have to go out on leave,” she said. “If you only have a few employees, it’s challenging to cover the work. … What helps when you have these kinds of policies is that it seems like things are a little bit more out in the open and they’re more formalized.”

The business community has raised objections to most of the parental leave policies that are already in place in the U.S., according to researchers. But after the policies have passed, the fervor of their opposition seems to die down, according to studies of how businesses responded in California and New York. 

The studies, which have largely been based on surveys of hundreds of businesses before and after the policies went in place, suggest that most businesses believe the policies had no impact or a positive impact.

Kaufman, who wrote a book comparing parental leave policies in Britain, the U.S. and Norway, said familiarity typically leads to increased support. “I think the more people who get to experience it and see it working,” she said, “the more likely there would be that push to get it at state and national levels.”

There is no evidence that businesses have moved across state lines to avoid parental leave policies, according to experts.

“Generally speaking, moving is quite costly,” said researcher Rossin-Slater. “ And so this does not seem like something that is sort of of the order of magnitude that would lead a business to choose to leave or move. But I don’t think we have fantastic evidence one way or another.”

In her comments to the Health Department, Pashman, the Allegheny Conference’s CEO, pointed out that much of the research on parental leave policies is from states that are less generous, available to fewer people and supported by a different funding mechanism. 

She believes this makes the county’s proposal riskier than what the research implies. “This combination of benefit level, scope, and funding structure is highly atypical and positions Allegheny County as an outlier among peer regions,” Pashman wrote.

The people with the most generous paid leave policies right now tend to work for some of the biggest and most influential companies in the country, according to researcher Kaufman. But even some of the country’s biggest companies don’t offer generous leave packages, she said, and that’s why public policies are important. Without them, “it’s completely up to who you work for.”

Rossin-Slater said there are studies that show government-funded paid leave programs can have a bigger impact on women who are unmarried, have less education or are minorities. These improvements can have lasting effects. One study in Norway showed a small decrease in high school drop-out rates and an increase in future earnings for the children of parents who took parental leave.

“The people that benefit the most from these types of policies are usually not the ones that are in the rooms deciding them,” Rossin-Slater said.

Even places that have passed generous paid leave policies don’t always see a benefit for disadvantaged groups. One study in San Francisco found that, in the years after a new policy passed, more advantaged groups saw bigger health improvements because they were better informed about the policies and more likely to be eligible. 

Other jurisdictions have found ways to ease the transition and reduce the economic effects of mandatory paid leave. 

New York offered 50% of a parent’s wage for eight weeks in 2018 and slowly increased that rate until parents were eligible for 67% of their wages over 12 weeks by 2021. Several states offer low-wage parents up to 90% of their wages while on leave, but offer 50% or 70% to women who earn more. Researchers say this could decrease the overall cost of the program while still preserving some of the desired health impacts.

Health Department officials have already signaled a willingness to adjust the proposal to overcome economic and political challenges. The department could make changes to the policy before it returns for a vote by the Board of Health, which could happen as soon as September.

“We are very thankful for all of the suggestions, all of the ideas and ways in which we can make this particular regulation even stronger than the first time around,” said department Director Vann at a July board meeting. The biggest issue of dispute, Vann said, was about how to pay for the policy rather than whether to have a policy.

If a policy is approved by the board for the Health Department, it will then move to the County Council where it would have to be approved again before taking effect.