Forty-three million Americans don’t have access to a single day of paid sick leave from work. Rebecca Feibel’s 16 years as a child-care worker have shown her what that does to families and communities.

Feibel, a member of the advocacy group Moms Rising, recalls one 4-year-old girl who was sent to day care with untreated pneumonia, risking the health of the staff and all the children. The girl’s parents both worked, had no access to paid sick or family leave, and couldn’t afford to lose a day’s wages. They also didn’t have access to a phone at their workplace, and Feibel couldn’t reach them when the girl became sick enough to need to be taken to the hospital in an ambulance.

“The child suffered not only from a serious illness, but also from the frightening prospect of an ambulance ride and a hospital visit without her family,” Feibel said. If one or both of the girl’s parents had paid sick leave, she added, they could have stayed home and cared for the girl, gone with her to the hospital if need be, and saved the day care from a serious infection risk.

Feibel spoke at a Thursday press conference along with Sen. Patty Murray (D-WA) and Rep. Rosa DeLauro (D-CT), who were announcing their reintroduction of the Healthy Families Act. The bill would give every worker in businesses with more than 15 employees the right to earn seven job-protected paid sick days per year, and seven unpaid sick days at smaller companies.

“No one should have to choose between their health and their economic security,” Murray said. “It’s not just unfair, it’s a public health risk. Nobody wants a restaurant worker coming in with a cold.”

The Healthy Families Act has been introduced in Congress every year since 2004, and every year it has failed to gain traction. In a Republican-dominated Congress, the bill’s odds seem even longer than usual.

But advocates for the bill think this is their year, and they have some reason to be optimistic.

While the press conference was happening, Philadelphia became the 17th U.S. city to pass a local law mandating paid sick days. Three states—Connecticut, California, and Massachusetts—mandate paid sick leave as well. The bulk of these advances at the city and state level have come just in the last two years, the fruits of a decade-long grassroots campaign.

“What a difference a few years makes,” said Debra Ness, president of the National Partnership for Women and Families.

Paid sick days became a winning issue for Democratic candidates like Connecticut Gov. Dannel Malloy and New York City Mayor Bill de Blasio, and advocates say this is because the benefits of such policies are obvious once voters learn about them. Everyone gets sick or needs to care for a sick relative, but not everybody can afford unpaid time off, and nobody wants to share public space with sick workers or children.

While opponents might cry “bad for business,” results so far say otherwise. Seventy percent of businesses approve of Seattle’s paid leave program, for instance, and businesses in the area have grown.

Dana Zemel, people operations coordinator at Blue Bottle Coffee, said some of her business’s locations mandated paid sick days, but giving them to all employees regardless of location made good business sense: There were fewer unplanned absences, it wasn’t an administrative or operational burden, and employees were happier and more productive.

But a patchwork of local laws isn’t enough, Zemel said. For all workers to enjoy the same benefits as those at her company, national legislation is needed. 

President Obama explicitly addressed the need for paid leave in his State of the Union address this year. That speech offered a comprehensive message about the economic burden put on families by lack of paid leave or the high costs of child care. Democrats in Congress are pushing other bills that would implement Obama’s pro-family policies, like the Right Start Child Care and Education Act, which would have the effect of tripling tax credits for working families with children. Sens. Barbara Boxer (D-CA), Brian Schatz (D-HI), Jeanne Shaheen (D-NH), and Kirsten Gillibrand (D-NY) reintroduced that bill this week.

Paid sick days are a boon for women, who shoulder disproportionate child-care responsibilities. They are often crucial for women seeking reproductive health care. And the Healthy Families Act, as well as other paid leave laws, also allow victims of domestic violence or sexual violence to take “safe days” to deal with the fallout from an assault.

Murray and DeLauro compared the fight for this legislation to the fight to pass the landmark Violence Against Women Act in 1994. “It passed in the Senate, and it was a bipartisan effort. But it was seven or eight months before it got passed in the House,” DeLauro said. “It was the outside pressure on members in the House that turned them around.”

Maryland state Sen. Catherine Pugh (D-Baltimore), who is working to pass sick leave legislation in her state, urged advocates to “roll up their sleeves” and call every governor, congress person, and council member who doesn’t understand what this legislation is about.

“‘The pressure comes from the public,” Pugh said.