A huge amount of those people working paycheck to paycheck don't have jobs that allow unpaid days off, let alone paid vacation days.
Even for minimally paid jobs and/or short term jobs the same laws apply, and the vacation days will be accumulated.
(Unpaid vacation should be a lesser problem, depending if a company will get by without your workforce for a time.)
If paid vacation really is not required in the US, how the hell do you get any vacation and recreation time? This is unhealthy and results in a lot of physical, mental and social degression.