By Diane Harris

This report explores the difficult choices Southern workers often face when serious illness, caregiving, childbirth, or family loss occur. Based on interviews with 10 workers, “Inaccessible and Costly” finds that limited access to paid family and medical leave means too many workers fear retaliation, return to work too soon, lose wages, fall into debt, or are pushed out of jobs altogether.

The report argues that these harms deepen poverty and inequity, especially for women of color, and calls for worker-centered paid leave policies with job protection, anti-retaliation measures, strong wage replacement, inclusive family definitions, paid sick days, and bereavement leave.

Since this report’s publication, Southern states have made progress on paid family and medical leave. In March 2026, Virginia’s General Assembly passed a comprehensive paid family and medical leave policy and Tennessee’s legislature expanded the state’s public sector paid parental leave policy. “Inaccessible and Costly” is in the process of being updated to recognize these historic wins.  

To learn more about the recent effort in Virginia, please visit this CLASP resource. To learn more about the bill passage in Tennessee, please refer to A Better Balance’s press statement.