For the second year in a row, Congress is considering a federal paid sick leave policy.

Known as the Healthy Families Act, the bill requires any employer with more than 15 workers to provide seven days of sick leave. The bill targets low- and middle-wage employees such as retail, grocery store and restaurant workers.

Nearly half the private sector workers in the United States and three in four low-wage workers don’t have sick leave – estimates are that 100 million workers are employed at companies that do not have a paid sick leave policy.

“If Congress passes this bill, millions of workers will no longer have to choose between a paycheck and recovery when they get sick or a family member needs care,” said Karen Minapelli, director of work and families at the National Partnership for Women and Children.

But opponents to the legislation say it is unnecessary. The National Federation of Independent Businesses said that small business owners voluntarily provide leave and paid time off for employees.

According to federation polls, 96 percent of small business owners provide flexible working hours for employees; 75 percent voluntarily offer some sort of paid sick leave and 67 percent of small business owners grant family leave as paid leave.

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“I’d like to know where they get their numbers,” said Stephanie Cathcart, spokeswoman for the NFIB. “Most likely, they are from human resource firms, and so many small businesses don’t use those kinds of firms.”

But with the onset of H1N1 flu virus, it is time for a federal paid sick leave policy, Minapelli said.

 “People can’t afford to go without pay,” she said. “And so they go to work sick. It’s really a public health issue.”

Companies with a paid-time-off plan can use that plan for sick leave purposes, she said. The bill offers flexibility for employers.

“Some businesses won’t have to add anything,” she said. “If they have a PTO program, then this will fit right into that.”

But not necessarily, Cathcart said. The bill doesn’t allow companies to reduce benefits, so the seven days will have to be added to the PTO plan.

Workers earn half a day of sick leave for every 30 hours worked, but the sick leave is capped at a total of 56 hours, or seven days.

“Of course, there will be costs to business,” Minapelli said. “But it’s minimal – really, when it comes down to it, this is a policy that needs to be in place. The costs really are offset by the benefit to workers and to the business, because sick people are less likely to be productive – something called presenteeism.”

The United States, Canada and Japan are the only countries among 22 industrialized nations that do not have government mandated sick leave. The United States has unpaid leave for up to 12 weeks to care for a sick family member, known as the Family Medical Leave Act, but no policy for short-term illnesses.

According to the U.S. Centers for Disease Control and Prevention, people with the flu – the regular, seasonal flu – should stay home when they are sick, the report said. But in reality, the CDC estimates that 20 million Americans go to work sick each flu season.

The report covers a variety of nations with different policies: some require employers to cover pay while workers are out sick; others operate social insurance systems in which the government provides sick pay using tax revenue. Most use a hybrid of the two systems.

Employers say there will be costs – but exactly how much is unknown. Luke Travins, co-owner of Concept Restaurants in Colorado Springs, said he is hoping that restaurants will be exempt from the law.

“We usually are exempt from labor laws because people get most of their pay from tips,” he said. “So, we’re exempt from things like minimum wage. But if we have to have this policy, it will cost us.”

The NFIB said costs will be determined by the size of the business and its pay scale. But the people who will really pay are employees.

“They may not hire anyone else if this bill passes,” Cathcart said. “That’s the real cost – unemployment.”

Other opponents point to widespread misuse of the Family Medical Leave Act. The Heritage Foundation, a public policy research group, said that workers abuse the act to obtain days off from work when they are not sick – and that the new legislation would allow for the same kind of abuse.

“This legislation … would radically change the current system of voluntarily provided sick leave by encouraging widespread misuse,” said James Sherk, Bradley Fellow in Labor Policy for the foundation. “Like the FMLA, the HFA would make it difficult for employers to verify that workers taking sick leave are actually sick. The act would allow workers to take up to three days of leave without any medical certification that the leave is necessary.”

The bill, as written, encourages abuse and fraud, he said.

“The biggest losers would not be businesses, but the customers and co-workers of dishonest employees,” he said. “When a worker takes intermittent leave or takes off work without providing advance notice, employers may not be able to find a replacement worker. Two-thirds of employers respond by reassigning the absent workers’ tasks to the conscientious employees still working.”

Cathcart said small businesses seldom benefit from federal mandates.

“We talk a lot about this ‘one size fits all’ policy that the federal government does,” she said. “What works for a company of 500 won’t work for a company of 15 – there are totally different working environments, totally different operations.”

The NFIB also is concerned about mandating this policy in the face of an ongoing recession.

“We are already in tough economic times,” she said. “It seems incredibly out of touch to be pushing to add more mandates on businesses already struggling to keep their doors open and people employed.”

Small business owners should be allowed to set appropriate wage and benefit levels, she said.

“Small business owners and their employees are like family – and they are already providing these benefits,” she said. “We are traveling down a dangerous path here. We need to let business owners do what they do best – grow their business so they can hire more people and help this economy.”