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A California lawmaker who rose to national prominence by pushing for some of the nation’s toughest vaccination laws is leaving the state legislature later this year after a landmark term that made him a top target of the vociferous and burgeoning anti-vaccination movement. vaccination mandates.
State Sen. Richard Pan, the bespectacled, unassuming pediatrician who continued to treat low-income children during his 12 years in the state Senate and Assembly, was physically assaulted and verbally attacked for working to tighten childhood vaccine requirements – even as Time magazine hailed him as a “hero.” Threats against him escalated in 2019, becoming so vicious that he required a restraining order and personal security.
“It got really vicious and the tone of these protests at the Capitol building didn’t make you feel safe, but he stood his ground,” said Karen Smith, director of the California Department of Public Health 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 tremendous 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 term limits, which limit state lawmakers to 12 years of service. He has overseen state health budget decisions and since 2018 has chaired the Senate Health Care Committee, a powerful position that allows him to shape health coverage for millions of Californians.
Pan, 56, helped lead the charge to restore vision, dental and other benefits to California’s Medicaid program, called Medi-Cal, after they were cut during the Great Recession. Since then, he has pushed for expanded social services for some of the most vulnerable students.
He helped implement California’s Affordable Care Act, and when Republicans attacked the law after Donald Trump was elected president, Pan spearheaded efforts to strengthen its provisions in state law. After the Republican-controlled Congress limited the federal coverage mandate in 2017, he led efforts to create a state penalty for not having health insurance. And he is negotiating with the governor to expand health insurance subsidies for low- and middle-income Californians.
In 2020, Pan created legislation that would put California in the generic drug business, starting 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 the quality of care for Medi-Cal enrollees — have been blocked by the powerful health insurance industry or opposition from his own party. And this year, Pan backed away from his controversial proposal to require students to be vaccinated against covid-19.
Pan has also faced criticism for being 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. In contentious political battles, such as those related to provider pay or physician authority, Pan often sides with his fellow physicians.
For example, he joined with the medical association against a long-sought attempt to allow nurse practitioners to practice without a physician’s supervision, a bill that was one of the association’s primary legislative goals but ultimately passed despite its fierce opposition. And two key bills that tried to rein in health care costs died in his committee after clearing the state Assembly — one in 2019 to limit surprise medical bills for emergency room visits and another this year to give powers to the state attorney general over some hospital and health care system mergers.
“He’s inseparable from the physician lobby and clearly carries water for the CMA,” said Jamie Court, president of the advocacy group Consumer Watchdog, arguing that Pan has stood in the way of progressive health care bills such as the proposal to create a government-run health care single payer system.
Pan dismissed claims that he was too close to the industry. “I’m proud to be a member of the CMA, but I don’t blindly follow the CMA,” he said. As for the nurse practitioner legislation, he said his concerns “came from my knowledge of professional medical education and how it affects patient outcomes.”
Pan isn’t running for anything this year, but he hasn’t ruled out running for office in the future. For now, he said he is focusing on his work in Sacramento until his term ends on Nov. 30. After that, he plans to practice medicine full time.
Pan said the public hasn’t heard the last of him when it comes to improving Medi-Cal. The state must do more to ensure high-quality care and fair access for the 14.5 million Californians enrolled in the low-income health care program, he said.
Pan said he entered politics to improve the health of the community. He left his job as a faculty member and director of the pediatric residency program at the University of California-Davis to run for the 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 authored a law that made it harder for parents to get personal faith exemptions for vaccines required for children entering public and private schools that prevent communicable diseases like measles and polio. In 2015, he succeeded in banning personal belief exemptions for students entirely.
In 2019, when lawmakers voted on Pan’s bill, which dismantled bogus medical exemptions for mandatory school immunizations, a protester threw menstrual blood on them in the Senate. Pan also clashed with Gov. Gavin Newsom, who softened the bill by asking for amendments that allow doctors to retain significant powers over exemptions. Newsom eventually signed the measure.
“I didn’t run for the legislature because I planned to do vaccine legislation, but I care about children and that’s what I’ve dedicated my life to,” said Pan, who earned a medical degree from the University of Pittsburgh and a master’s degree in public health from Harvard University. “We had a whooping cough epidemic and 10 babies died. I was very concerned about the fact that we could prevent these diseases and yet we were failing.”
Pan introduced legislation this year requiring covid vaccinations for school-aged children, but withdrew it in April, saying it would be difficult for California officials to enforce it. At the time, the covid vaccination rate for schoolchildren “was too low at about 30%,” Pan said. He concluded that the state should redouble its efforts to increase vaccination rates before implementing a mandate.
Pan also noted that covid-19 mutates rapidly and that emerging research shows that vaccines are not very good at fighting new variants. “The vaccine is a very effective protection against death, but its ability to slow transmission appears to be diminishing,” Pan said. “Unfortunately, it was also so politicized, so we have more work to do.”
As chair of the California Asian and Pacific Islander Legislative Caucus, Pan helped secure a $157 million investment in 2021 to combat violence and hate crimes against Asian Americans and was a powerful force advocating for more money for the state’s beleaguered health care system — a battle Democrats finally won last year when Newsom approved $300 million in current funding.
State Sen. Scott Wiener (D-San Francisco) said Pan has inspired his interest in introducing tough vaccination and public health bills, and that he regularly seeks Pan’s advice before unveiling legislative proposals. “I would call him randomly all the time,” Wiener said. “There really isn’t anyone in the Senate with the experience and knowledge that he has.
Smart and studious, Pan regularly delves into scientific evidence during legislative debates. Interviews with reporters often lead to lengthy discourses about the history of the US health care system — such as the time when the question of hospital funding led to a lesson about how hospitals are both for-profit enterprises and institutions that provide charity care.
“How serious you are about any endeavor — it can really be a joy and a pain,” said Senate Leader Tony Atkins, who tenderly thanked Pan for his work in the Senate in mid-August. “You took a lot of criticism from people in a lot of ways and through it all your integrity, your sense of humor and your very good nature withstood it all.”
This story was produced by KHN, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.
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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health policy research organization not affiliated with Kaiser Permanente.
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