SACRAMENTO, Calif. — A California lawmaker who gained national notoriety for muscling through some of the nation’s strongest vaccination laws is leaving the state legislature later this year after a key term that made him a top target of a buoyant and growing movement against vaccination mandates. .
State Sen. Richard Pan, an eye-popping and unassuming pediatrician who continued to treat low-income children during his 12 years in the state Senate and Assembly, has been physically assaulted and verbally attacked — even praised by Time magazine — for working to tighten childhood vaccine requirements. As a “hero”. Threats against him intensified in 2019, becoming so violent that he required a restraining order and private security detail.
“It’s become really scary, and you don’t feel safe during these protests inside the Capitol building, yet 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 knowledge and faith in science, but also the conviction to act on it.”
“It takes courage,” he added. “He’s had a tremendous impact in California, and there’s going to be a hole in the Legislature when he’s gone.”
The Democrat from Sacramento is leaving the Capitol because of legislative term limits that limit state lawmakers to 12 years in office. He has overseen state budget decisions related to health care and has chaired the Senate Health Committee since 2018, 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 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 the expansion of social services to some of the most vulnerable enlisted.
He was instrumental in implementing the Affordable Care Act in California, and when Republicans attacked the law after Donald Trump was elected president, Pan led the move to cement its provisions into state law. After the Republican-controlled Congress dropped the federal coverage mandate in 2017, he led efforts to create state penalties for not having health insurance. And he negotiated with the governor to expand health insurance subsidies for low- and moderate-income Californians.
In 2020, Pan introduced legislation that would put California in the business of making generic drugs, starting with insulin.
“What drives me is my commitment to health and healthy communities,” Pan told KHN.
But he was not always successful. Some of his bills — including those to expand benefits and improve the quality of care for Medi-Cal enrollees — were stalled by opposition from the influential health insurance industry or his own party. And this year, Pan backed down on his controversial proposal to require school children to be 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 on behalf of doctors in Sacramento. In controversial policy battles, such as provider pay or dealing with physician authorities, Pan often sided with his fellow doctors.
For example, he rallied with doctors’ associations against a long-sought attempt to give nurse practitioners the ability to practice without physician supervision—a bill that had been one of the association’s top legislative goals but ultimately passed despite strong opposition. And two key bills that sought to rein in health care spending died in committee after clearing the state Legislature — one to limit surprise medical bills for emergency room visits in 2019 and another this year to give state attorneys general authority over some hospitals and health care. System integration
“He’s integral to the doctors’ lobby, and obviously he carries water for the CMA,” said Jamie Court, president of the advocacy group Consumer Watchdog, arguing that Pan stands in the way of progressive health care bills such as a proposal to create a government-run, single-payer system. Healthcare system.
Pan rejects 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, she said, her concerns “come from my knowledge of professional medical education and how it affects patient outcomes.”
Pan isn’t running for anything this year but isn’t ruling out the possibility of doing so in the future. For now, he said, he’s 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 equitable access for the 14.5 million Californians enrolled in low-income health programs, he said.
Pan said he entered politics to improve the health of society. He left his job as a faculty member and head of the pediatric residency program at the University of California-Davis in 2010 to run for the State Assembly. He served two terms before being elected to the state Senate in 2014.
Early on, he found himself at the forefront of California’s battle over the vaccination mandate.
In 2012, he introduced legislation that made it more difficult for parents to get a personal belief exemption for vaccinations that are required for children entering public and private schools and that prevent infectious diseases such as measles and polio. In 2015, he succeeded in completely banning the personal belief exemption for schoolchildren.
In 2019, when lawmakers were voting on PAN’s bill that cracked down on bogus medical exemptions for required school immunizations, a protester threw menstrual blood at them on the Senate floor. Pan also clashed with Gov. Gavin Newsom, who shot down the bill after demanding amendments that would have allowed doctors to retain significant authority over exemptions. Newsom eventually signed the measure.
“I didn’t run for the Legislature because I was planning to create vaccine legislation, but I care about children and that’s what I’ve dedicated my life to,” said Pan, who received his medical degree from the University of Pittsburgh and a master’s degree in public health from Harvard University. “We had an outbreak of whooping cough and 10 children died. And I was very concerned that we could prevent these diseases, yet we failed.”
This year, PAN introduced legislation to require Covid vaccinations for school-aged children but pulled it in April, saying it would be difficult for California officials to enforce it. At the time, the Covid vaccination rate for schoolchildren was “very low – about 30%,” Pan said. He concluded that the state should redouble its efforts to increase vaccination rates before establishing a mandate.
Pan also noted that Covid-19 was changing rapidly and that emerging research indicated that vaccines were not very good at combating the new variants. “The vaccine is very effective at protecting against death, but the ability to reduce infection appears to be diminished,” Pan said. “Unfortunately, it’s also been so politicized, so we have more work to do.”
As chair of California’s 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 public health system — ultimately a battle Democrats fought last year. The year was won when Newsom approved $300 million in ongoing funding.
State Sen. Scott Wiener (D-San Francisco) said PAN has inspired his interest in introducing tougher vaccination and public health bills, and he regularly seeks PAN’s advice before unveiling legislative proposals. “I would randomly call him all the time,” Wiener said. “There’s really no one in the Senate with his experience and knowledge.”
Intelligent and studious, Pan regularly delved into scientific evidence during legislative floor debates. Interviews with journalists often result in long lectures about the history of the US health care system—for example, a question about hospital financing leads to a lesson about how hospitals are profit-making enterprises and institutions that provide charity care.
“How serious you are about every initiative — it can be really a joy and a bore,” said Senate Leader Tony Atkins, who thanked Pan fondly for his work on the Senate floor in mid-August. “You’ve taken a lot of criticism from people in many ways, and through it all, your honesty, your sense of humor and your very good nature have endured.”
This story was produced by KHN, which publishes California Healthline, the editorially independent service of the California Health Care Foundation.
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