A growing number of liberal states have passed paid sick leave laws in recent years, assuring workers get paid time off to care for themselves or their loved ones when theyre ill. Now some conservative states might be getting in on the act, too.

Campaigns in Nebraska , Missouri and Alaska have secured enough signatures to put sick leave measures on their ballots this November. If voters approve them, the laws would let workers start accruing one hour of paid sick time for every 30 they work, capped at 56 hours per year at large employers and 40 at small ones.

More than a dozen states have similar mandates on their books, according to A Better Balance, a nonprofit advocate for fair and supportive workplaces. But none of those states are as red as Nebraska, Missouri or Alaska, all of which former President Donald Trump won handily in 2016 and 2020.

If the ballot measures succeed, it would demonstrate just how popular paid sick days are among the general public.

What weve realized in talking to thousands of Nebraskans is that this is a really commonsense issue, said Jo Giles, director of the Womens Fund of Omaha, one of the advocacy groups backing the initiative in Nebraska. Most people have been sick at some point in their working lives and have needed to take time off.

Giles said the typical voter sympathizes with someone who has to choose between a days pay and taking care of a child whos home sick from school. The campaign, called Paid Sick Leave for Nebraskans , includes small-business owners who havent balked at the idea of a new mandate, she added.

The U.S. is an outlier among wealthy countries in not guaranteeing workers sick leave or other paid time off. The lack of a federal mandate means employers dont have to offer any paid time off unless there is a state or local ordinance dictating otherwise. (The Family and Medical Leave Act of 1993 guarantees extended leave under certain circumstances, but it doesnt have to be compensated.)

About 80% of workers have access to paid sick days , meaning 1 in 5 dont, according to estimates from the Bureau of Labor Statistics. And those who lack them fall disproportionately near the low end of the pay scale: Only 40% of workers in the bottom decile of wages can call out sick and still get paid.

Richard von Glahn, a spokesperson for the Missouri campaign, called Missourians for Healthy Families and Fair Wages, said the people who need the mandate most are those who were referred to as essential throughout the COVID-19 pandemic: child care workers, restaurant workers, retail workers, etc.

Access to paid sick days is definitely something that has a class element to it, said von Glahn, whos also political director at the worker center Missouri Jobs With Justice. For people who are making over $100,000 a year, its very common. But its not as common for frontline workers who really drive the economy.