One of the biggest problems facing the United States during the coronavirus pandemic is a lack of paid leave for workers.

Even though health officials recommend that anyone who feels sick stay home from work to help slow the spread of the virus, many Americans risk losing pay — or their jobs — if they stay home. And with schools and daycare centers closed across the country, many parents have few job protections if they take time off to care for their kids.

Congress aimed to fix that this week with the Families First Coronavirus Response Act, which was supposed to help workers across the country take care of themselves and their loved ones in this time of national crisis. President Trump even praised the bill on Saturday, citing “good teamwork” between Democrats and Republicans.

Good teamwork between Republicans & Democrats as the House passes the big CoronaVirus Relief Bill. People really pulled together. Nice to see! — Donald J. Trump (@realDonaldTrump) March 14, 2020

But after amendments by Republicans on Monday, the bill could leave out millions of Americans who work for small businesses. The amendments also limited paid family leave to parents dealing with school closures — leaving out people who need to stay home because a family member was exposed to the virus or is displaying symptoms.

Overall, the bill — which is expected to pass in the Senate — may solve some of the glaring problems with the American social safety net that the coronavirus crisis has exposed. But the fact that so many workers and situations aren’t covered “adds up to a giant individual health and financial security risk, as well as a giant community health risk,” Vicki Shabo, a senior fellow for paid leave policy and strategy, at the New America Foundation’s Better Life Lab, told Vox.

As much as health experts and government officials are telling Americans to stay home right now to avoid spreading the virus, “people literally cannot necessarily afford to do that,” Shabo said. “We all pay the price.”

Republicans created loopholes in the new sick-leave bill that could hang employees out to dry

Nearly 200 countries around the world guarantee paid sick leave to workers, according to PRI. As Vox’s Dylan Scott notes, it’s often seen as an issue of simple justice: People shouldn’t lose their jobs or income just because they get sick. But the US isn’t among those 200 countries, and large swathes of American workers lack paid time off — for example, just 27 percent of those whose wages fall in the bottom 10 percent in the country have access to sick leave.

That’s always been a public health risk as well as an individual one, and now it’s even more so, since coronavirus spreads easily from person to person and experts say one of the best ways to contain it is for everyone — especially the sick — to keep their distance.

That’s why guaranteeing some form of paid sick leave has been a big priority for lawmakers in this time. The Families First Coronavirus Response Act does that, guaranteeing two weeks of paid sick leave to people who are sick or quarantined because of Covid-19, as well as caregivers for family members who are sick.

But there are big exceptions. Businesses with more than 500 employees are exempt — something the White House and congressional Republicans demanded before they would support the bill, according to the New York Times. This includes corporations like McDonald’s and Amazon, which employ millions (though many of those corporations have said they will voluntarily provide paid sick time during the crisis).

And now because of amendments introduced on Monday — also under pressure from Republicans — the bill now also exempts businesses with fewer than 50 employees and many health care providers, if the Labor Department determines that offering paid leave “would jeopardize the viability of the business as a going concern,” the Times reports.

About 59 million Americans work for businesses with more than 500 employees, according to the Times, and about 6.5 million of them have no paid sick days. Meanwhile, 12 million Americans working at small businesses have no paid sick leave. These workers could be forced to choose between following CDC recommendations and keeping their jobs. (That’s not counting the roughly 16 million workers who are self-employed, including gig economy workers, who may receive a tax credit under the legislation to offset sick leave costs.)

The bill was also supposed to address family leave, a crucial issue as parents nationwide are now without a source of child care as thousands of schools close. And the current version of the bill will provide 12 weeks of paid leave total to parents of children whose schools are closed, at 67 percent of the worker’s normal pay, up to $200 a day.

But small and large businesses are also exempted from this provision, leaving their employees potentially without benefits. Meanwhile, an earlier version of the bill allowed workers to take paid time off to care for a family member with symptoms or who had been exposed to the virus, but this portion was also removed during the amendment process.

The new version of the bill also allows employers to designate employees as necessary health care personnel and exempt them from paid benefits. And yet “there’s no accommodation for child care in this bill for those workers, and there’s also obviously a public health concern with having health providers and emergency responders potentially going to work after having been exposed to and exhibiting symptoms of the virus,” Shabo said.

Overall, the bill does move toward solving some of the problems laid bare by the coronavirus epidemic, and keeping workers and their families safe. But, Shabo said, the exemptions in the legislation show that “we’re still a nation of haves and have-nots when it comes to access to paid sick time and paid family and medical leave.”