Voters in Missouri and Nebraska approved ballot measures Tuesday that guarantee paid leave for sick workers. Alaska voters seem poised to pass a similar measure that has a wide lead.

These two Republican-led states join 15 others and D.C. — largely Democratic-controlled places — in requiring some employers to provide workers with paid sick leave.

Proponents cheered Tuesday’s results. “Thanks to the voters, we can ensure that hard working Nebraskans don’t have to choose between paying their bills or caring for their health,” Jodi Lepaopao, campaign manager for Paid Sick Leave for Nebraskans, wrote in a statement.

The coronavirus pandemic elevated the issue by highlighting gaps in such benefits. At the height of the health crisis, the federal government provided temporary relief for sick workers, but those federal protections ended in 2021.

Beginning next year, many workers in these two states will be able to accrue paid time off as they work, earning about a week of paid leave per year. In Missouri and Nebraska, workers for larger organizations could earn one hour of paid sick time for every 30 hours worked. In Alaska, eligible workers would accrue a maximum of 56 hours of paid time each year.

In Missouri and Alaska, the measures also called for boosting the minimum wage.

Opponents in Missouri said they were disappointed with Tuesday’s results and were exploring legal action.

“We stand by our belief that Missouri business owners are best equipped to run their businesses without additional government mandates and regulations,” according to a joint statement from the Missouri Chamber of Commerce and Industry, the National Federation of Independent Business and other business groups.

Opponents had argued that employers should be the ones deciding which benefits are best.

These paid sick leave ballot measures flew under the radar compared with more high-profile ballot initiatives such as those on abortion, which was on the ballot in 10 states, including in Missouri and Nebraska. Voters approved abortion protections in seven states.

Campaigns supporting the sick leave initiatives in Alaska, Missouri and Nebraska raked in less than $9 million combined in cash contributions, according to a KFF Health News analysis of state campaign filings as of Oct. 28. That’s significantly less than Missouri’s ballot measures on abortion and sports betting, which state records show had amassed more than $55 million combined in cash contributions.

Most of the money funneled to the paid sick leave campaigns came from backers outside those states, the filings show. The Sixteen Thirty Fund, a D.C.-based advocacy group, was a top contributor to the three campaigns.

“We will build on these victories and continue to support organizations fighting for paid leave policies nationwide,” the group said in a statement.

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