That number could shrink slightly on Tuesday when voters head to the polls. The upcoming midterm elections are expected to shift control of the Senate from Democrats to Republicans, but in these four locations across the country, as voters choose candidates, they’ll also consider ballot initiatives to guarantee workers paid sick days:

• Voters in Massachusetts could make the state the third in the country to guarantee paid sick days by passing a law that will allow an employee to earn one hour of sick time for every 30 hours worked. So far, only Connecticut and California have done the same.
• Residents of Trenton and Monclair, New Jersey could join a growing number towns in the state that promise workers paid sick leave by voting on ordinances that would allow private sector workers to earn one hour of paid sick time for every 30 hours worked. A bill that would give paid sick days to New Jersey private sector employees state-wide made its way through the state assembly’s labor committee last week—a big hurdle on its way to becoming law. Newark and Jersey City have already enacted a paid sick leave law and similar policies have garnered approval in Paterson, Passaic, Irvington, and East Orange.
• Oakland, California voters will have the opportunity to require employers to give workers at least five paid sick days per year. The state of California passed a state-wide paid sick day law in September, but it only guarantees three paid days off.

If the four initiatives are approved by voters, it will cap off what’s been a successful 12-month span for advocates of paid sick days.

“This year has seen a tremendous number of wins legislatively that have more than doubled the number of locations with paid sick leave and tripled the number of people who will be able to [access] paid sick days,” says Ellen Bravo, executive director of Family Values@Work.

The absence of federal legislation ensuring paid sick leave is a vestige of a time when only one parent worked while the other provided primary care to children and older adults, according to a report by the Economic Policy Institute. Senator Edward Kennedy first called on Congress to address the issue when he introduced the Healthy Families Act in 2004, but it went nowhere. Senator Tom Harkin and Representative Rosa DeLauro reintroduced the measure in 2013. Those bills are in committee. Not having paid sick days forces parents to make a tough choice between taking care of a sick child or getting paid. According to 2010 report by the National Opinion Research Center, moms and dads without paid sick leave are twice as likely to send a sick child to school and are fives times as likely to take a child or relative to the emergency room because they can’t take time off during the day for a doctor’s visit.

Which workers have sick days and which ones don’t is a distinction made mainly along income lines. Nearly nine out of 10 private sector employees who earn the top 10% of wages have access to paid sick days, compared to 20% of people who earn wages in the lowest 10%, according to the Bureau of Labor Statistics. The absence of paid sick days is especially prevalent in the service industry, where 60% of workers don’t have the benefit.

Connecticut was the first to pass a state-wide law guaranteeing paid sick leave in 2011. Nearly three years later, the Center for Economic and Policy Research found that the law had little or no negative effect on business in the state. Opponents of paid sick days contend otherwise. When the California law passed, John Kabateck, executive director of National Federation of Independent Businesses in California, said that the policy and the state’s high minimum wage rate would “only serve to eliminate any plans small employers have to grow and expand their businesses.”

Despite fierce resistance from the business community, the paid sick day movement is expected to grow, even after November 4. In six states—New Jersey, Maryland, Minnesota, Oregon, Vermont, and Washington—there are active campaigns pushing for legislation that would establish the benefit state-wide, Bravo says. What’s responsible for such progress? “The sky didn’t fall,” she says. “We have a growing body of research from places that have already done it that proves [that paid sick days are] helpful for workers and families and not a burden to business.”