Why Paid Family Leave Falls Short for Sandwich Generation Caregivers

Pennsylvania’s proposed paid leave legislation, known as the Family Care Act, represents a significant shift in state support for caregivers, but the proposal may fall short of meeting the needs of the “sandwich generation.” These caregivers, typically adults in their 40s and 50s, face the simultaneous demand of raising children while supporting aging parents.

The number of family caregivers in the United States has grown from 53 million in 2020 to 63 million as of 2025. This population is expected to continue increasing as the baby boomer generation ages and encounters the limitations of existing health and social services systems.

Family caregivers are defined as unpaid individuals who provide assistance to a family member requiring support due to aging, disability, or illness. Because these individuals often lack medical training or guidance on navigating social services, they face a high risk of mental and physical strain. This pressure can lead to burnout and may force caregivers to leave the workforce before they reach retirement age, a trend that disproportionately affects women.

For the sandwich generation, the emotional and financial pressures are intensified by being positioned between two generations of dependents. Without formal protections such as paid leave, these individuals often feel compelled to turn down promotions, reduce their working hours, or exit the workforce entirely to manage unpredictable caregiving demands.

The Family Care Act

Democratic Rep. Jennifer O’Mara proposed the Family Care Act to address these gaps in support. The legislation has seen different approaches in the state’s legislative chambers.

The Pennsylvania House approved a version of the bill in March 2026. This version would allow employees to take up to 12 paid weeks off to care for a family member during a serious illness or following the birth of a child. According to Spotlight PA, the House-approved bill proposes that employers cover the costs, with grants made available for small businesses.

A separate version of the act was pending in the state Senate’s Labor & Industry Committee as of May 2026. The Senate version would fund benefits through employee payroll deductions of up to 1% of their income. This would address a gap in federal law, which currently guarantees only unpaid leave.

The act proposes a partial wage replacement of 90% of wages. The weekly benefit would be capped between $573 and $995, depending on the individual’s earnings. While this wage replacement aims to ensure lower- and middle-income workers do not have to choose between a paycheck and family care, it may still be insufficient for those facing high out-of-pocket caregiving expenses.

Comparative State and Federal Support

Pennsylvania’s proposal follows policies already implemented in other states. California offers up to eight weeks of paid family caregiving leave, replacing up to 90% of wages for lower earners. Washington and Massachusetts both provide up to 12 weeks of leave, with wage replacement rates of 90% and 80%, respectively, and include job protections.

At the federal level, the Older Americans Act funds caregiver support, transportation, and meal delivery, while Medicaid Home and Community-Based Services allows older adults to receive care at home. The RAISE Family Caregivers Act outlines government actions to help caregivers better balance their employment with their caregiving responsibilities. However, systemic barriers and eligibility gaps continue to limit the reach of these programs.

Limitations for Chronic Caregivers

Despite the potential benefits, the Family Care Act is designed to supplement standard sick days rather than replace them. It focuses on intermittent leave for singular events, such as surgery or childbirth. In contrast, caregiving for the sandwich generation is often chronic and resource-intensive.

Research indicates that sandwich generation caregivers often use the majority of their existing paid time off for caregiving tasks, leaving little time for their own health needs. Because the Family Care Act caps paid leave at 12 weeks per year, it may not provide enough flexibility for those managing long-term, overlapping needs.

because the benefit is tied to employment, it may not reach the caregivers who need it most—those who have already left the workforce or reduced their hours to provide care.

Regional Impact in Pittsburgh

The challenges are particularly acute in metro Pittsburgh, which U.S. Census Bureau data identifies as one of the oldest populations in the country. In Allegheny County, the number of residents age 65 and older is projected to grow by 50,000 by 2050.

Caregivers in Pittsburgh face a “generational tug-of-war,” attempting to manage eldercare while securing affordable childcare. Childcare in Allegheny County has become a growing problem due to limited available spots and staffing shortages.

Without a universal federal mandate or a flexible state policy, access to paid leave remains uneven. This is especially true for part-time employees, lower-wage workers, and those employed by small businesses, who often lack guaranteed access to the time off required to meet these dual obligations.