Nevadans still pushing for paid leave, prescription drug provisions cut from spending plan

Tameka Henry’s financial stability was most recently threatened when she had to take an unpaid month off work in December because she and her daughters were sick from Covid.

Since 2006 when her husband was diagnosed with a gastrointestinal chronic illness, she has juggled his hospital stays, finding child care, and her job, and on multiple occasions had to take periods of time off from work, unpaid, in order to manage.  

That unpaid time, she estimated, could amount to more than $200,000. 

“It’s a lot of money,” she said. “I had to make that decision. Do I stay at home and care for (my husband) and my family or do I go to work?”

The United States is one of six countries in the world without any sort of national paid leave policy.

When Democratic lawmakers proposed over the summer to invest in climate change and dramatically expand the social safety net — a package that was estimated to cost $3.5 trillion over a decade — long sought after policy priorities like offering 12 weeks of paid family and medical leave and efforts to lower prescription were included. 

However, a new framework for the Build Back Better Act put forward by President Joe Biden Thursday revealed a trimmed-down investment to $1.75 trillion over a decade, which omitted both proposals. 

The final details of the bill are still being worked out, and many lawmakers who have pushed for both policies argue there is still a chance variations of them could be included in the final package. 

Henry, who was once excited by the possibility of 12-weeks of paid leave, is now angry that the importance of a national policy is still being debated. 

“If you strip these policies away that are so desperately needed, if you strip them from this package, I don’t see how we can recover,” she said. “I don’t see how we can Build Back Better if we have sick Americans, with nobody to care for them and with no affordable prescription drugs. What are we doing?” 

“The difference between living and dying”

Quentin Savwoir, the deputy director of Make it Work Nevada, said paid leave “means the difference between living and dying.”

“There are folks who go years without going to the doctor because they know they don’t have access to having time off,” he said. “Having time off means they can’t put gas in the car at the end of the week or they can’t go to the store.”

He said one woman he met while organizing around paid leave “lived with this chronic pain for all these years to find out it was endometriosis and that she could no longer have kids.”

After years of trying, Nevada passed paid leave legislation in 2019, which went into effect in 2020.

But the policy only allows for five days for full-time workers per year, and only applies to businesses with 50 or more employees.

“You’ve seen some corporations unilaterally do this, which is what lets me know this is wholly possible.” Savwoir said. “It’s not that companies don’t think it’s needed. They absolutely know it’s needed. It would just require a significant investment in their workforce.”

Organizers have long pushed for efforts to implement a national policy, and talks of a federal paid leave program began to ruminate in Washington early this year.

As Senate Democrats were announcing their budget reconciliation package in August, advocates mounted a public push to sing the praises of a paid leave policy. “Nobody should have to choose between staying safe, protecting their children and getting a paycheck so they can put food on the table,” Nevada Democratic Rep. Dina Titus said at a Las Vegas event at the time.

That budget reconciliation package in announced in August included a pathway to citizenship, expanding the child tax credit, investing in climate change, developing universal Pre-K, increasing access to affordable child care, building affordable housing and of course offering a paid family and medical leave policy, along with multiple other proposals. 

Without Republican support, Senate Democrats could only pass the legislation through a process known as reconciliation which bypasses a Senate filibuster but would require all 50 Democratic senators along with Vice President Kamala Harris to break the tie in order to pass. 

Democratic Sens. Joe Manchin and Kyrsten Sinema have not only bulked at the price tag but also components of the package, leading to months-long debate on what will and won’t be included. 

Rumors of alternative paid leave proposals have floated around, including reducing the policy from 12 week to four weeks or focusing on parental leave, both of which would have left out millions of people, Henry said. 

“What about that sandwich generation who are caring for their children but also have parents they are taking care of,” she said. “I can’t use it to take care of my parents? If you only have parental (leave), you’re leaving out so many Americans.”

Henry’s husband fell ill in 2006, which led to lengthy hospital stays and caused her to repeatedly miss work. 

“He could do really well for a couple of months,” she said. “Then there are times he is in the hospital every week. He would have severe stomach pains, vomiting, and couldn’t hold down food. He’s diabetic and his sugar levels would be out of whack. So he would have to have 24 hour care here at home or if it was severe he would be hospitalized.”

On average, she added, he was hospitalized 15 days every month for the first couple years. 

Henry, who worked doing in-home caretaking and assisted living services, wasn’t able to afford a home care worker herself. She had to figure out how to take care of her family and how to work. 

Despite two years on the job, the need to take days off resulted in her being fired six months into her husband’s diagnosis. 

“There was no paid leave, I was taking a risk,” she said. “I would take off, and wouldn’t get paid for it. Ultimately my job said they weren’t able to do this. They had to let me go. I couldn’t even be mad at that. The same services I provided I now needed.”

Although her husband’s condition stabilized several years ago, the lack of paid leave still hurts the family. 

Henry works for a small nonprofit with less than 50 people so doesn’t qualify for the state’s paid leave. When she got Covid and missed work, she had to seek help from family members, work odd jobs like braiding hair, and ran through the little savings accumulated in order to get by and pay rent. 

“We tried to save for a rainy day, but it seems like every day was a monsoon.” she said.

But the crisis isn’t over. Now she is dealing with long hauler symptoms caused by Covid. 

“I have days I need to take off because I’m just so tired,” she said. “It comes out of nowhere. Headaches that come out of nowhere. Numbness out of nowhere. Things you didn’t have before. I’m not the only one going through this. How do you build back better without having a comprehensive paid family and medical leave plan in place to keep people working?”

Savwoir thought out of all things that would have highlighted the urgency to pass a national leave policy, it would have been the pandemic. 

“What else do you need in order to prove that you need paid time off from work when you get sick?,” he said. “I think the pandemic created an entry for us to have a more amplified conversation.”

“I just don’t have that kind of money”

The new framework for the Build Back Better Act still provides significant investments and in a statement Thursday, Annette Magnus, the executive director of Battle Born Progress, applauded it for “historic investment in infrastructure, and social programs, as well as reforming our tax structure to finally make the ultra rich pay their fair share.”

But her organization has also called for items like paid family and medical leave as well as efforts to lower prescription drug costs, saying they were reforms that Nevadans were expecting.

“As we’ve watched Nevadans struggling to pay for medication before the pandemic, struggle even worse in the time since, we’re now witnessing Big Pharma being allowed to make it even harder for many of those people,” she said. 

One of those Nevadans is Steve Horner, who in 2004 was diagnosed with chronic obstructive pulmonary disease, which causes breathing-related issues and could cause an airflow to be blocked.

In order to survive, the main treatment he uses costs about $400 a month after the deductible. 

“Before the deductible it’s $1,100 a month and I need this daily,” he said. 

A “rescue inhaler” costs about $250, but it’s not something he needs monthly. 

His doctor wanted to put him on another medication that would have “decreased the amount of the exacerbations that I have, but it was $1500 a month.”

“That was after the deductible. I decided not to go with it,” he said. “I’m a retired teacher and I just don’t have that kind of money. It’s ridiculous because I have friends up in Canada and they pay a fraction of the cost.”

When he was first diagnosed with COPD, he was still working as a teacher and was able to afford treatments through his insurance. 

“I had to leave my job because of my illness,” he said. “It got to the point I couldn’t work anymore.”

Even with his supplemental insurance he’s had since retiring eight years ago, there are months he has to figure out how to make the high costs work. 

He too thought the pandemic would convince policymakers to address prescription drug costs. 

“I was hoping when we shut down this country and we have people at home, nobody working, nobody in schools, I had hoped they would open their eyes and see the need,” he said. 

High prescription drug costs have also plagued Henry’s family, since her husband relies on insulin for his diabetes and for treating his chronic illness. 

“Sometimes, my husband gets prescriptions not covered by insurance,” she said. “They’d say, “Oh, it’s just a $400 copay.’ What? Where am I supposed to get that from?”

Three House Democrats along with Sinema, all of whom receive significant donations from pharmaceutical companies, had opposed provisions in the bill that would have allowed Medicaid to negotiate drug prices. 

“It is unacceptable to allow Big Pharma and the Billionaire Band to continue to hold a monopoly over the medications that everyday Nevadans need the most,” Magnus said. “We’ve watched people lose jobs, homes, and livelihoods over the past 20 months. During this time we have observed pharmaceutical corporations and the billionaires who own their stock increase their wealth astronomically.”

Henry said whether or not the final legislation includes a paid leave policy or rein in prescription drug prices, “one way or another, you’re going to pay for it.” 

“The best investment would be to invest in the care infrastructure or you’ll pay for it on the other side,” she said. “As we’re talking about Building Back Better, it’s past time for them to make investments in our care infrastructure, for our caretakers, for our families who need paid medical leave, for our citizens who need affordable prescription drugs. It’s all about care.”