The employee was concerned about costs, including uncovered medical costs with insurance [0], which is why they didn't take family leave (which the US federally only guarantees unpaid, and the state the employee was in has no state paid family leave—though both his previous state and the one he declined to move to for the job do have paid family leave.)

So, both public health insurance policy and public employee benefits policy in the US, as well as Amazon's particular practices (employees aren't prevented from providing paid leave or reduced demands without a mandate), are involved in this case.