When Michael Cockrell, a cook and dishwasher in Philadelphia, was sick with the flu, he showed up for work anyway. When his 5-year-old son was hospitalized with an asthma attack, Cockrell still punched the clock.

“If I wasn’t fearful of being terminated, I wouldn’t have gone to work either of those times,” said Cockrell, 30. “You can cover your mouth, but those germs are microscopic. You don’t know where they’re going and what food they’re landing on.”

If lawmakers in New York City, Massachusetts, Washington state and Vermont get their way, workers like Cockrell who call in sick wouldn’t risk being fired or losing a day’s wages. Similar measures won approval last week in Portland, Oregon, and Philadelphia, where a bill awaits the mayor’s signature.

Supporters [including Make the Road New York] are pushing for paid sick leave because they say the Family and Medical Leave Act, which President Bill Clinton signed 20 years ago, doesn’t go far enough. The landmark bill granted as much as 12 weeks of job-protected, unpaid leave to new parents and workers who are ill or whose dependents are. Yet 40 percent of all workers aren’t covered because it applies only to employees working more than 25 hours a week at businesses of 50 people or more.

The act also didn’t enable recovery of lost wages and applied only to serious illness, not routine conditions such as colds and the flu. Proponents have been fighting to expand the measure ever since, concentrating their efforts at the state and local level.

Opponent’s Success

Forty-four million Americans don’t have paid sick leave, according to Family Values @ Work, a nonprofit group leading 20 state and local coalitions backing paid-leave laws. In places where such policies are in place — Connecticut, Seattle, Washington, San Francisco and Long Beach, California — workers earn a minimum number of days a year, depending on the size of their employer. They can use the time off to care for themselves or dependents. The smallest workplaces are sometimes exempt.

Opponents, including the National Federation of Independent Businesses, have been busy, too. They’re backing proposed state laws in Florida, Washington and Michigan that seek to stem the spread of paid sick leave by cutting off the ability of municipalities to impose it. Wisconsin, Mississippi and Louisiana already have passed such measures, which backers say help avoid a hodgepodge of local laws.

The National Restaurant Association, the biggest industry trade association, is part of a coalition of business groups opposed to mandatory sick-leave policies. In 2011, it helped fund a campaign to defeat a voter initiative in Denver.

Punishing ‘Everybody’

“The people in the best position to decide what’s best for a local business is a local business, not some policy makers in some far-away capital,” said Jack Mozloom, a spokesman for the federation in Nashville, Tennessee. “These laws punish everybody.”

Mozloom cited a February survey by the Washington-based Employment Policies Institute that found that some employers in Connecticut cut jobs and reduced benefits after the state law took effect last year. The institute is one of several groups created by Washington-based public relations executive Rick Berman. The groups have promoted issues favored by the restaurant, beverage and tobacco industries.

Momentum for mandatory paid sick leave is building because business owners are increasingly speaking out in favor of the policies, said Ellen Bravo, executive director of Family Values @ Work in Milwaukee. Municipalities that have them are giving advocates a growing body of evidence that refutes predictions of doom used by opponents to dissuade lawmakers from passing them, she said.

Tipping Point

“We’re seeing a wave of wins that will move us closer to the tipping point,” Bravo said. “And the tipping point is when Congress says, ‘What are we doing? Why aren’t we passing this?’”

On March 20, U.S. Representative Rosa DeLauro of Connecticut and Senator Thomas Harkin of Iowa, both Democrats, introduced the Healthy Families Act, which would set a federal mandate allowing employees to earn as many as seven paid sick days a year. Advocates say it has little chance of passing.

In 2006, San Francisco became the first U.S. city to adopt a mandatory sick-leave policy. A study conducted by the Washington-based Institute for Women’s Policy Research, which supports the law, found that six of seven businesses reported no negative effect on profits.

“Sometimes you need a little shove to do the right thing,” said James Freeman, who founded Oakland, California- based Blue Bottle Coffee Co. in 2002. After being forced to provide his San Francisco workers with paid leave, the company now offers it to all 248 employees in its 10 locations, four of which are in New York, where such a policy isn’t mandated.

Low Wages

Low-wage workers are the least likely to have paid sick leave and are often employed in industries with high levels of public interaction, such as food service and child care, according to Family Values @ Work. People who go to work when sick put everyone’s health at risk, the group says. Job- retention policies like paid leave can help reduce turnover and strengthen the economy, it says.

That’s why Yvonne Thomas, who runs six day-care centers in Philadelphia, offers her more than 100 employees paid leave even though the city doesn’t yet require it.

Sick employees are “not going to be the upbeat energetic people I need them to be to work with children,” Thomas said. “It’s like a two-way street — I expect things from my employees and I expect to give them things as a result.”

Nutter’s Decision

Philadelphia Mayor Michael Nutter, a Democrat, has until April 4 to act on his city’s legislation. The bill, which backers say would benefit 180,000 residents, would require that workers earn seven paid sick days a year if they work at a business of 20 or more, and four days if it’s smaller. Businesses employing five people or less would be exempt.

The city council passed the law 11-6, one vote short of the two-thirds majority needed to override a potential veto. Nutter vetoed a similar bill in 2011, saying it would make the city less competitive. Cockrell, the cook, spoke in support of the new measure.

Nutter isn’t the only Democrat opposing sick-leave laws. In Denver, voters’ rejection came after Mayor Michael Hancock and Governor John Hickenlooper, both Democrats, spoke out against it. In New York City, Council Speaker and Democratic mayoral candidate Christine Quinn has angered paid-leave advocates by blocking such a measure from coming to a vote. The bill, co- sponsored by 38 of the 51 council members, would harm New York’s economic recovery, she says.

Michael Bloomberg, New York’s mayor and founder and majority owner of Bloomberg News parent Bloomberg LP, has long been against paid sick leave. Other candidates vying to replace him, such as Public Advocate Bill de Blasio, have attacked Quinn for blocking a vote, and activists including Gloria Steinem have threatened to pull their support if she doesn’t change course.

The council plans a hearing on the issue today.

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