A California lawmaker who has risen to national prominence enforcing some of the toughest vaccination laws in the country is leaving the state legislature later this year after a momentous term that made him a prime target of the loud and booming anti-vaccination movement.
State Senator Richard Pan, a bespectacled and unassuming pediatrician who continued to treat low-income children during his 12 years in the state Senate and Assembly, was physically and verbally abused for working to tighten vaccine requirements for children – even as Time magazine hailed him as a “hero”.“The threats against him escalated in 2019, becoming so violent that he required a restraining order and personal security details.
“It got really vicious, and the tenor of these protests inside the Capitol building didn’t make you feel safe, but it held on,” said Health Department director Karen Smith. California public from 2015 to 2019. “Dr. Pan is unusual because he has the knowledge and belief in science, but also the conviction to act on it.
“It takes courage,” she added. “He had a huge impact in California, and there will be a hole in the legislature when he’s gone.”
The Sacramento Democrat is leaving the Capitol because of legislative limits that restrict state legislators to 12 years of service. He oversaw state budget decisions on health care, and since 2018 he has chaired the Senate Health Committee, a powerful position that has allowed him to shape health care coverage for millions of Californians.
Pan, 56, helped lead the charge to restore vision, dental care and other benefits from California’s Medicaid program, called Medi-Cal, after they were cut during the Great Recession. Since then he has pushed to develop social services to some of the most vulnerable registrants.
He was instrumental in implementing the Affordable Care Act in California, and when Republicans attacked the law after Donald Trump was elected president, Pan spearheaded measures to cement his provisions in state law. After the Republican-controlled Congress abolished federal blanket mandate in 2017, he led the creative effort state sanction for not having health insurance. And he negotiated with the governor to extend health insurance subsidies to low- and middle-income Californians.
In 2020, Pan copyright law that will put California in the generic drug manufacturing business, start with insulin.
“What drives me is my commitment to health and healthy communities,” Pan told KHN.
But he didn’t always succeed. Some of his bills — including those to expand benefits and improve quality of care for Medi-Cal enrollees — have been blocked by the influential health insurance industry or opposition from his own party. And this year, Pan backtracked on his controversial proposal to force schoolchildren to get vaccinated against covid-19.
Pan has also faced criticism that he is too closely aligned with the health care industry, including the California Medical Association, or CMA, a deep-pocketed group that lobbies in Sacramento on behalf of doctors. On contentious political battles, such as those dealing with supplier compensation or medical authorityPan often sided with his fellow physicians.
For example, he joined the medical association against a longstanding attempt to give nurse practitioners the ability to practice without medical supervision – a bill that was one of the association’s main legislative targets, but which eventually passed despite its vehement opposition. And two key bills that aimed to rein in health care costs died in his committee after being approved by the state assembly – one in 2019 at limit surprise medical bills for emergency room visits and another one this year give the state attorney general authority over certain hospital and health system mergers.
“He’s inseparable from the doctor lobby, and obviously he’s hauling water for the CMA,” said Jamie Court, president of advocacy group Consumer Watchdog, saying Pan had opposed progressive bills on health care such as proposal to create a government-run, single-payer health care system.
Pan dismissed claims that he is too close to the industry. “I’m proud to be a member of the CMA, but I don’t just blindly follow the CMA,” he said. When it comes to nurse practitioner legislation, he said, his concerns “came from my knowledge of professional medical education and how that influences patient outcomes.”
Pan isn’t showing up for anything this year but isn’t ruling out the possibility of doing so in the future. For now, he says, he’s focused on his job in Sacramento until his term ends Nov. 30. After that, he plans to practice medicine full-time.
Pan said the public hasn’t heard from him when it comes to improving Medi-Cal. The state must do more to ensure high-quality care and equitable access for the 14.5 million Californians enrolled in the low-income health program, he said.
Pan said he entered politics to improve community health. He left his position as a faculty member and director of the University of California-Davis Pediatrics Residency Program to run for State Assembly in 2010. He served two terms before being elected to the State Senate in 2014.
Early on, he found himself at the forefront of California’s wars over vaccination mandates.
In 2012 he drafted a law making it more difficult for parents to obtain personal belief exemptions for vaccines that are required for children entering public and private schools and that prevent communicable diseases such as measles and poliomyelitis. In 2015, he succeeded in prohibit personal belief exemptions absolutely for school children.
In 2019, when lawmakers were voting on Pan’s bill that cracked down on fake medical exemptions for mandatory school vaccinations, a protester threw menstrual blood at them on the floor of the Senate. Pan also clashed with Governor Gavin Newsom, who watered down the bill demanding amendments that allowed physicians retain significant authority over exemptions. Newsom eventually signed the measure.
“I didn’t run for parliament because I was planning to legislate vaccines, but I care about children and that’s what I’ve dedicated my life to,” said Pan, who graduated in Medicine from the University of Pittsburgh and a Masters in Public Health from Harvard University. “We had a whooping cough outbreak, and 10 infants died. And I was very concerned that we could prevent these diseases, but we were failing.
This year, Pan introduced legislation require covid vaccinations for school-aged children but i removed it in april, saying it would be difficult for California authorities to enforce. At the time, the covid vaccination rate for schoolchildren “was too low – around 30%,” Pan said. He concluded that the state should redouble its efforts to increase vaccination rates before instituting a mandate.
Pan also noted that covid-19 mutates rapidly and emerging research indicates that vaccines are not very effective in combating new variants. “The vaccine is very effective in protecting against death, but its ability to slow transmission appears to be diminishing,” Pan said. “Unfortunately, it has also been so politicized, so we still have work to do.”
As chairman of California’s Asian and Pacific Island Legislative Caucus, Pan in 2021 raised $157 million investment to address violence and hate crimes against Asian Americans and was a a powerful force advocating for more money for the state’s beleaguered public health system — a democrat fight finally won last year when Newsom approved continued funding of $300 million.
State Sen. Scott Wiener (D-San Francisco) said Pan inspired his interest in introducing tough immunization and public health bills and that he regularly sought Pan’s advice before unveiling legislative proposals. “I was randomly calling him all the time,” Wiener said. “There really isn’t anyone in the Senate with the experience and knowledge that he has.”
Intelligent and studious, Pan regularly delves into scientific evidence during parliamentary debates. Interviews with reporters often culminate in long speeches about the history of America’s healthcare system – such as the time a question about hospital funding led to a lesson in how hospitals are both businesses at for-profit and institutions that provide charitable care.
“How serious you are about every undertaking – it can really be a joy and an irritation,” said Senate Leader Toni Atkins, who affectionately thanked Pan for his work on the Senate floor in mid-August. “You received a lot of criticism from people in many ways, and through it all, your integrity, your sense of humor and your very good nature withstood it all.”
