OCTOBER • 2012 NCPA PAC UPDATE National Community Pharmacists Association Political Action Committee

P1. NCPA Political Action P2. Pharmacy Bills Continue to P4. Analysis of Obama vs. Romney P7. NCPA PAC Supports a Bi- Committee News. Gain Support in Congress. Medicare/ Proposals. Partisan Roster of Candidates.

ELECTION GUIDE

NCPA Political Action Committee (NCPA PAC) News IT’S OCTOBER AND THE HALLS OF CONGRESS ARE EMPTY! In addition to the Presidency being up for grabs, one third of the Senate and every member of the House of Representatives is at home pounding the campaign trail as they prepare for the up- coming election. While the majority of the nation’s attention will be on the presidential election, there will be literally hundreds, if not thousands, of races in that have the potential to impact community pharmacy. The results may have significant implications for the future of the Medicare, Medicaid, and the new health care reform law, all programs of importance for community pharmacy.

Presidential Race Update Source: The Cook Political Report

Thank you to all of our NCPA PAC supporters this election cycle. As a distinguished PAC member, you should hold your head high. Without your support, independent community pharmacy would have gone unnoticed.

The race for President is still close, with both party conventions over and the candidates’ bounces having largely subsided. With President Obama needing 270 electoral votes to 100 Daingerfield Road 100 Daingerfield Road Alexandria, VA 22314-2888 Alexandria, VA 22314-2888 win a second term, the map above outlines the current electoral vote ratings. ■ ELECTION GUIDE

Senate Races Update Pharmacy Bills Source: The Cook Political Report Continue to Gain Support in Congress NCPA has continued to educate Members of Congress and their staffs about NCPA’s legislative priorities and bills. A list of mem- bers that have signed on to each bill is be- low. Please support these Members of Con- gress that support Community Pharmacy.

The Medicare Access to Diabetes Supplies Act (H.R. 1936): H.R. 1936 would ensure that Medicare beneficiaries will be able to continue to obtain diabetes testing sup- plies and counseling services they receive from small pharmacies by exempting these pharmacies from the DME competitive bidding program. Seniors would also be Current Senate Lineup: 51 Democrats, 47 Republicans, 2 Independents (33 seats up in 2012) able to continue to obtain home delivery With Democrats holding a 53-47 majority in the chamber (including independents of their testing supplies from these same who caucus with the Democrats) Republicans would need to gain a net of at least three small pharmacies. seats—four if they fail to win the presidency. And both sides have said it’s about a 50-50 prospect. ■ Lead Sponsors: Rep. Schock, Aaron [IL-18] & Rep. Welch, Peter [VT-AL] House Races Update Rep. Bachus, Spencer [AL-6] Source: The Cook Political Report Rep. Berg, Rick [ND-AL] Rep. Boren, Dan [OK-2] Rep. Castor, Kathy [FL-11] Rep. DeGette, Diana [CO-1] Rep. Duncan, John J., Jr. [TN-2] Rep. Ellmers, Renee L. [NC-2] Rep. Gibbs, Bob [OH-18] Rep. Goodlatte, Bob [VA-6] Rep. Griffith, H. Morgan [VA-9] Rep. Harper, Gregg [MS-3] Rep. Hinojosa, Ruben [TX-15] Rep. Jackson, Jesse L., Jr. [IL-2] Rep. Jenkins, Lynn [KS-2] Rep. Kissell, Larry [NC-8] Rep. Latham, Tom [IA-4] Rep. Latta, Robert E. [OH-5] Rep. Lewis, John [GA-5] Rep. Lipinski, Daniel [IL-3] Rep. Luetkemeyer, Blaine [MO-9] Current House Lineup: 240 Republicans, 190 Democrats, 5 Vacancies Rep. McKinley, David B. [WV-1] With Republicans holding a 240-190 majority, Democrats would need gain a net of 25 seats Rep. Meehan, Patrick [PA-7] to take the majority. Political pundits are currently predicting a net shift of between two Rep. Pascrell, Bill, Jr. [NJ-8] seats for Republicans and eight seats for Democrats. ■ Rep. Perlmutter, Ed [CO-7] ELECTION GUIDE

Rep. Peterson, Collin C. [MN-7] Rep. Paul, Ron [TX-14] Rep. Herrera Beutler, Jaime [WA-3] Rep. Posey, Bill [FL-15] Rep. Perlmutter, Ed [CO-7] Rep. Hinchey, Maurice D. [NY-22] Rep. Roe, David P. [TN-1] Rep. Platts, Todd [PA-19] Rep. Hinojosa, Ruben [TX-15] Rep. Ross, Mike [AR-4] Rep. Posey, Bill [FL-15] Rep. Jackson, Jesse L., Jr. [IL-2] Rep. Schiff, Adam B. [CA-29] Rep. Roby, Martha [AL-2] Rep. Johnson, Hank [GA-4] Rep. Schilling, Robert T. [IL-17] Rep. Rogers, Mike D. [AL-3] Rep. Jones, Walter B., Jr. [NC-3] Rep. Scott, David [GA-13] Rep. Ross, Dennis [FL-12] Rep. Kildee, Dale E. [MI-5] Rep. Terry, Lee [NE-2] Rep. Schiff, Adam B. [CA-29] Rep. Kissell, Larry [NC-8] Rep. Tonko, Paul [NY-21] Rep. Scott, Austin [GA-8] Rep. Loebsack, David [IA-2] Rep. Towns, Edolphus [NY-10] Rep. Smith, Adrian [NE-3] Rep. Marino, Tom [PA-10] Rep. Westmoreland, Lynn A. [GA-3] Rep. Welch, Peter [VT] Rep. Michaud, Michael H. [ME-2] Rep. Westmoreland, Lynn A. [GA-3] Rep. Peterson, Collin C. [MN-7] The Preserving Our Hometown Inde- Rep. Young, Todd C. [IN-9] Rep. Scott, Austin [GA-8] pendent Pharmacies Act of 2011 (H.R. Rep. Scott, David [GA-13] 1946): H.R. 1946 would create a more The Pharmacy Competition and Con- Rep. Terry, Lee [NE-2] competitive marketplace for the delivery sumer Choice Act of 2011 (H.R. 1971/S. Rep. Towns, Edolphus [NY-10] of pharmacy services by enhancing the 1058): H.R. 1971/S. 1058 would result in Rep. Weiner, Anthony D. [NY-9] ability of independent community phar- greater choice of pharmacies for consum- Rep. Welch, Peter [VT] macies to negotiate with pharmacy ben- ers. It would provide vital information Rep. Westmoreland, Lynn A. [GA-3] efit managers (PBMs). to health plans to help them better assess Rep. Young, Todd C. [IN-9] whether their PBM is doing all it can to Lead Sponsor: Rep. Marino, Tom [PA-10] lower prescription drug costs. It would The Medicare Pharmacy Transparency Rep. Aderholt, Robert B. [AL-4] also create fair standards for PBM audits and Fair Auditing Act (H.R. 4215): H.R. Rep. Andrews, Robert E. [NJ-1] of pharmacies that are understandable and 4215 would address problematic PBM Rep. Bachus, Spencer [AL-6] consistent with state laws governing phar- practices in Medicare by addressing egre- Rep. Barletta, Lou [PA-11] macy practice. gious audits and requiring that PBMs’ Rep. Bartlett, Roscoe G. [MD-6] audit standards cannot exceed those re- Rep. Bishop, Timothy H. [NY-1] Lead Sponsors: Sen. Pryor, Mark [AR] quired by state or federal law. It would also Rep. Boren, Dan [OK-2] & Sen. Moran, Jerry [KS] require PBM transparency regarding how Rep. Boswell, Leonard L. [IA-3] Sen. Boozman, John [AR] PBMs determine their Maximum Allow- Rep. Butterfield, G. K. [NC-1] Sen. Cochran, Thad [MS] able Cost (MAC) pricing. Rep. Capito, Shelley Moore [WV-2] Sen. Conrad, Kent [ND] Rep. Coble, Howard [NC-6] Sen. Johnson, Tim [SD] Lead Sponsors: Rep. McMorris Rodgers, Rep. Crawford, Rick [AR-1] Sen. Wicker, Roger [MS] Cathy [WA-5] & Rep. Ross, Mike [AR-4] Rep. Ellmers, Renee L. [NC-2] Rep. Amodei, Mark E. [NV-2] Rep. Emerson, Jo Ann [MO-8] Lead Sponsors: Rep. McMorris Rodgers, Rep. Andrews, Robert E. [NJ-1] Rep. Fitzpatrick, Michael G. [PA-8] Cathy [WA-5] & Rep. Ross, Mike [AR-4] Rep. Bishop, Sanford D., Jr. [GA-2] Rep. Fortenberry, Jeff [NE-1] Rep. Barletta, Lou [PA-11] Rep. Bishop, Timothy H. [NY-1] Rep. Gerlach, Jim [PA-6] Rep. Bishop, Timothy H. [NY-1] Rep. Boren, Dan [OK-2] Rep. Gohmert, Louie [TX-1] Rep. Boren, Dan [OK-2] Rep. Boswell, Leonard L. [IA-3] Rep. Herrera Beutler, Jaime [WA-3] Rep. Boswell, Leonard L. Rep. Boustany, Charles W., Jr. [LA-7] Rep. Hinojosa, Ruben [TX-15] Rep. Braley, Bruce L. [IA-1] Rep. Braley, Bruce L. [IA-1] Rep. Jones, Walter B., Jr. [NC-3] Rep. Castor, Kathy [FL-11] Rep. Butterfield, G. K. [NC-1] Rep. Kissell, Larry [NC-8] Rep. Connolly, Gerry [VA-11] Rep. Chu, Judy [CA-32] Rep. Lucas, Frank D. [OK-3] Rep. Courtney, Joe [CT-2] Rep. DesJarlais, Scott [TN-4] Rep. McIntyre, Mike [NC-7] Rep. Critz, Mark S. [PA-12] Rep. Doggett, Lloyd [TX-25] Rep. McMorris Rodgers, Cathy [WA-5] Rep. Doggett, Lloyd [TX-25] Rep. Fortenberry, Jeff [NE-1] Rep. Michaud, Michael H. [ME-2] Rep. Fitzpatrick, Michael G. [PA-8] Rep. Gerlach, Jim [PA-6] Rep. Palazzo, Steven M. [MS-4] Rep. Gingrey, Phil [GA-11] Rep. Griffith, H. Morgan [VA-9] ELECTION GUIDE

NCPA Analysis of Obama vs. Romney Medicare/ H.R. 1451 Cont’d Rep. Hastings, Doc [WA-4] Medicaid Proposals Rep. Hinojosa, Ruben [TX-15] Rep. Jones, Walter B., Jr. [NC-3] With Mitt Romney’s selection of Wisconsin Congressman Paul Ryan as his running mate, Rep. Kissell, Larry [NC-8] the issue of Medicare and Medicaid entitlement reform will be front and center in the Rep. Latham, Tom [IA-4] Presidential campaign. And that should be no surprise. The three main Federal entitle- Rep. Lipinski, Daniel [IL-3] ment programs – Medicare, Medicaid and Social Security—comprise a majority of Federal Rep. Loebsack, David [IA-2] spending, meaning that any serious attempt at Federal deficit reduction will involve major Rep. Marino, Tom [PA-10] changes to these programs. Rep. Owens, William L. [NY-23] Rep. Peterson, Collin C. [MN-7] Independent community pharmacy has a huge stake in potential changes to these programs Rep. Poe, Ted [TX-2] given that Medicare Part D and Medicaid prescriptions represent about half of the aver- Rep. Schakowsky, Janice D. [IL-9] age independent pharmacy’s business. While the new Congress would have to make these Rep. Schiff, Adam B. [CA-29] sweeping changes to these programs, get ready to hear more about turning Medicare into Rep. Scott, Austin [GA-8] a “premium support” model, which would likely increase the prevalence of managed care in Medicare. Under this program, seniors would be provided with an annual fixed subsidy Rep. Scott, David [GA-13] to purchase a comprehensive health insurance product from Federally-approved plans. It Rep. Terry, Lee [NE-2] is possible that policymakers will also make changes to the Medicare Part D donut hole Rep. Welch, Peter [VT] program, which was enacted as part of the Obamacare health care law. The program helps Rep. West, Allen B. [FL-22] to defray the costs of medications when seniors fall into the infamous Part D coverage gap. Rep. Westmoreland, Lynn A. [GA-3] Rep. Wittman, Robert J. [VA-1] We will also hear more about turning Medicaid into a “block grant” program, which would Rep. Young, Todd C. [IN-9] give states significantly more flexibility in how they administer their Medicaid programs, including their prescription drug programs. Other Medicaid changes could include reduc- ing the matching monies that states receive from the Federal government for traditional Independent community pharma- Medicaid patients as well as those enrolled in the state children’s health insurance program. cists are facing many challenges. Finally, repeal of the Obamacare law could eliminate the Medicaid expansion set to begin The government affairs staff is busy in 2014, where millions of more Medicaid patients could be added to states’ Medicaid rolls. promoting a pro-pharmacy agenda, Lots of moving pieces, so it’s important for community pharmacy to make sure our voice is including fighting against mail order heard with Members of Congress that will decide the fate of these programs. incentives in Tricare, fighting for an exemption to independent commu- The following is an analysis of the candidates’ Medicare and Medicaid proposals as well as nity pharmacies from Medicare Part predictions as to how these proposals will impact community pharmacists. The data found B competitive bidding for diabetes within the President Obama/Vice President Biden column is an analysis of information re- testing supplies, and supporting leg- leased by President Obama, such as the President Obama FY 2013 Budget Proposal, as well islation to require PBM transparency. as an analysis of the (ACA), which was signed into law by President We make progress on these fronts Obama and recently upheld as constitutional by the Supreme Court. every day, but we need your engage- ment. Let members of Congress The data found within the Mitt Romney/Paul Ryan column is a compilation of information know there is support for these released by candidate Mitt Romney as well as information found within Paul Ryan’s Chair- man’s mark of the FY 2013 House Budget Resolution and the Chairman’s report entitled, positions back home. Please visit “The Path to Prosperity: A Blueprint for American Renewal.” Chairman Ryan’s budget the NCPA Legislative Action Center proposal is included in this analysis due to the fact that Mitt Romney states on his website at www.ncpa-actioncenter.com to that the legislation introduced by Paul Ryan, “almost precisely mirrors” his ideas. (See www. learn more about how you can be in- mittromney.com/issues/medicare). volved. Also, please continue to sign up your patients for Fight4RX (www. fight4rx.org) because patients too are affected by these issues. Please contact Michael Rule at 703-838- 2671 for more information. ELECTION GUIDE

Medicare Proposals President Obama/Vice President Biden Proposal Romney/Ryan Proposal Eligibility Age No changes to current eligibility age. Seniors currently over age 55 would remain in the traditional Medicare program. Individuals currently under the age of 55, beginning in 2023, would be eligible for new options. Structure of Medicare No changes to the current structure of Medicare. Would convert the current Medicare program to a fixed federal contribution program. In this program, individuals eligible for Medicare after 2023 could enroll in FFS Medicare or a private insurance plan through a Medicare Exchange. The federal government would pay a portion of the benefi- ciary’s premiums which would be adjusted for geography and health status. Beneficiaries would pay the difference. In its report CBO has cautioned that under the new system, beneficiaries would bear a much larger share of their health care costs than under the current program and private plans would cost more than traditional Medicare due to different payment rates to providers. Part D Prescription Drug Prior to the ACA, most enrollees paid all drug costs during Based on provisions in Chairman Ryan’s FY 2012 Budget Benefit Coverage Gap the period between an initial coverage limit and a cata- Proposal as well as statements by Romney that he would (Doughnut Hole) strophic coverage anytime there was a gap in coverage. repeal the entire ACA, we are assuming that the Romney/ This gap is known as the doughnut hole. The ACA, which Ryan plan would repeal the provisions in the ACA regarding was signed into law by President Obama, phases out the closing the doughnut hole. doughnut hole and eliminates the doughnut hole in 2020. In 2020, 75% of the cost of generic drugs and 25% of the cost of brand name drugs incurred during the coverage gap would be subsidized by Medicare. Identifying/Combatting Strong emphasis on reducing fraud, waste, and abuse in Strong emphasis on reducing fraud, waste, and abuse in Fraud, Waste, and Abuse Medicare and on electronic health records. Medicare. Funds targeted increases in anti-fraud accounts.

Medicaid Proposals President Obama/Vice President Biden Proposal Romney/Ryan Proposal Structure of Medicaid The ACA expands Medicaid eligibility levels for nonelderly Repeals all Medicaid expansion provisions enacted under System individuals up to 133% of the federal poverty level and the ACA. In addition, the current Medicaid program would increases the federal matching payments for certain groups be converted to a block grant system starting in FY 2013. of beneficiaries effective in 2014. Under the United States Federal funding to states would increase annually according Supreme Court’s recent ruling, expansion of Medicaid is to inflation. optional for states. Pursuant to the ruling, if a state chooses not to expand its Medicaid program to the newly eligible defined under the ACA, the state will continue to receive its current federal matching payments but not receive the ad- ditional incentive federal matching payments. Medicaid Waiver Process Expands state flexibility to provide benchmark benefit pack- Eliminates waiver process. ages. Medicaid Reimbursement Would implement reimbursement rates for DME based on No changes to current system. for DME Medicare rates. Federal reimbursement for Medicaid spend- ing on certain DME services would be limited. ELECTION GUIDE

Impact On Community Pharmacists Medicare Under the Romney/Ryan proposal • Creates a Medicare Exchange: Beneficiaries eligible for Medicare after 2023 would choose either FFS Medicare or private insurance from a Medicare Exchange. • Issues Federal Subsidies: Beneficiaries would receive a federal subsidy to be used toward the premiums of the plan that they choose. This subsidy would be for the amount of the second least expensive plan within the Exchange. • Increases Managed Care: Providers could see an increase in beneficiaries’ out-of-pocket expenses and private insurance reimbursement. Beneficia- ries might purchase less expensive plans regardless of coverage and may postpone seeking medical treatment. This proposal will likely increase the prevalence of managed care. • Increases Medicare Beneficiaries in the Doughnut Hole: If the doughnut hole provisions are repealed, community pharmacists could see more Medicare beneficiaries reaching the Part D prescription drug benefit coverage gap.

Medicare Under the Obama/Biden proposal • Eliminates Doughnut Hole: Community pharmacists will continue to see the doughnut hole phased out and fully eliminated in 2020. • Shifts Additional Costs to Beneficiaries: The cost-sharing and out-of-pocket increases in Part B could shift additional costs to beneficiaries resulting in beneficiaries waiting to seek medical treatment. This could decrease payment to providers in the short-term and drive up health care costs in the long-run. • Increases Fraud, Waste, and Abuse Efforts: Regardless of whether Obama/Biden’s proposal or Romney/Ryan’s proposal is implemented, commu- nity pharmacists can expect to see increased efforts in targeting fraud, waste, and abuse within Medicare and Medicaid.

Medicaid Under the Romney/Ryan proposal • Establishes a Block Grant: Generally, block grants offer states more flexibility in administering programs. • Proponents of the block grant argue that a state could have the ability to decrease current requirements under Medicaid and relieve some of the state’s costly Medicaid burden. • Opponents argue that this shift in responsibility would leave the extra Medicaid spending that is over the block grant designated amounts to the states and caution that states may look at decreasing provider reimbursement under Medicaid as a method of meeting this cost burden. • Repeals Medicaid Expansion: Community pharmacists would also see a full repeal of the Medicaid expansion found within the ACA.

Medicaid Under the Obama/Biden proposal • Implements Medicaid Expansion: If a state chooses to expand its Medicaid program to include nonelderly individuals up to 133% of the federal poverty level, community pharmacists could see a drastic increase in Medicaid beneficiaries, depending on their state’s current eligibility levels. If an increase in Medicaid occurs, then all the concerns with current Medicaid beneficiaries, such as lower Medicaid reimbursement, will also increase. • Decreases DME Reimbursement: The proposal provides very little detail as to the implementation of the Medicaid DME reimbursement provision. However, the President has made statements regarding adopting “more efficient” payments for DME under Medicaid and proposes this as a cost saver. To be a cost saver, reimbursements to providers could decrease.

Congressional Pharmacy Caucus NCPA thanks the leadership of Representatives Cathy McMorris Rogers (R-WA-5) and Mike Ross (D-AR-4) in the U.S. House of Rep- resentatives and Senators Jerry Moran (R-KS) and Jon Tester (D-MT) in the U.S. Senate for forming the Community Pharmacy Cau- cus’s that are critical to advancing legislative priorities for community pharmacies.

The Caucus’ efforts extend beyond pushing for passage of legislation to include educating their colleagues and the public about the value of community pharmacies to our health care system.

House Community Pharmacy Rep. Joe Courtney (D-CT) Rep. Brett Guthrie (R-KY) Caucus Co-Chairs Rep. Geoff Davis (R-KY) Rep. Maurice D. Hinchey (D-NY) Rep. Cathy McMorris Rodgers (R-WA) Rep. Lloyd Doggett (D-TX) Rep. Tim Holden (D-PA) Rep. Mike Ross (D-AR) Rep. Jo Ann Emerson (R-MO) Rep. Jesse Jackson Jr. (D-IL) Rep. Jeff Fortenberry (R-NE) Rep. Lynn Jenkins (R-KS) Members Rep. Virginia Foxx (R-NC) Rep. Eddie Bernice Johnson (D-TX) Rep. Robert Aderholt (R-AL) Rep. Jim Gerlach (R-PA) Rep. Walter B. Jones (R-NC) Rep. John Barrow (D-GA) Rep. Bob Goodlatte (R-VA) Rep. Steve King (R-IA) Rep. Jaime Herrera Beutler (R-WA) Rep. (R-AR) Rep. Bob Latta (R-OH) ELECTION GUIDE

Rep. Dan Lipinski (D-IL) Rep. Mike Rogers (R-AL) Senate Community Pharmacy Rep. Frank LoBiondo (R-NJ) Rep. Mike Ross (D-AR) Caucus Co-Chairs Rep. Dave Loebsack (D-IA) Rep. Linda T. Sanchez (D-CA) Sen. Jim Moran (R-KS) Rep. Blaine Luetkemeyer (R-MO) Rep. Aaron Schock (R-IL) Sen. Jon Tester (D-MT) Rep. Carolyn McCarthy (D-NY) Rep. Peter Sessions (R-TX) Rep. Jim McGovern (D-MA) Rep. Louise Slaughter (D-NY) Members Rep. Mike McIntyre (D-NC) Rep. Steve Stivers (R-OH) Sen. Kent Conrad (D-ND) Rep. Mike Pompeo (R-KS) Rep. Glenn Thompson (R-PA) Sen. Tim Johnson (D-SD) Rep. Bill Posey (R-FL) Rep. Paul Tonko (D-NY) Sen. Bernie Sanders (I-VT) Rep. David Price (D-NC) Rep. Greg Walden (R-OR) Sen. Charles Schumer (D-NY) Rep. Tom Reed (R-NY) Sen. Debbie Stabenow (D-MI)

NCPA PAC Supports a Bi-Partisan Roster of Candidates The NCPA PAC is proud to have supported the following candidates who have demonstrated their commitment to our profession, our busi- nesses and our patients. These candidates understand the importance of community pharmacy and together they form the foundation of a “Community Pharmacy Majority” necessary for legislative success in Congress. We are encouraging pharmacists, their employees and patients to support these candidates on or before November 6th, and to get involved in their campaigns.

Candidate State District Candidate State District Shelley Adler (D) NJ 3 Rep. Dave Camp (R) MI 4 Rep. Rodney Alexander (R) LA 5 Rep. John B. T. Campbell, III (R) CA 45 Rep. Mark E. Amodei (R) NV 2 Rep. Francisco Canseco (R) TX 23 Rep. Louis J. Barletta (R) PA 11 Rep. Eric Cantor (R) VA 7 Sen. John Barrasso (R) WY Sen. Maria Cantwell (D) WA Rep. Joe L. Barton (R) TX 6 Sen. Benjamin L. Cardin (D) MD Rep. Charles F. Bass (R) NH 2 Sen. Thomas Carper (D) DE Rep. Xavier Becerra (D) CA 34 Matthew A. Cartwright (D) PA 17 Rep. Daniel J. Benishek (R) MI 1 Sen. Robert P. Casey, Jr (D) PA Rep. Rick Berg (R) ND AL Rep. William Cassidy (R) LA 6 Rep. Robert Bishop (R) UT 1 Rep. Katherine Anne Castor (D) FL 14 Rep. Timothy H. Bishop (D) NY 1 Rep. Steve Chabot (R) OH 1 Rep. Diane Black (R) TN 6 Rep. Judy Chu (D) CA 27 Rep. Marsha Blackburn (R) TN 7 Rep. Howard Coble (R) NC 6 Rep. John A. Boehner (R) OH 8 Rep. Gerald E. Connolly (D) VA 11 Rep. Jo Bonner, Jr. (R) AL 1 Rep. John Conyers, Jr. (D) MI 14 Rep. Mary Bono Mack (R) CA 36 Sen. Bob Corker (R) TN 0 Rep. Leonard L. Boswell (D) IA 3 Rep. Joseph D. Courtney (D) CT 2 Rep. Charles W. Boustany, Jr. (R) LA 3 Rep. Rick Crawford (R) AR 1 Rep. Bruce L. Braley (D) IA 1 Rep. Joseph Crowley (D) NY 14 Sen. Sherrod Brown (D) OH Rep. Henry Roberto Cuellar (D) TX 28 Sen. Scott Brown (R) MA Rep. Diana L. DeGette (D) CO 1 Rep. Michael Burgess (R) TX 26 Rep. John D. Dingell (D) MI 15 Rep. G. K. Butterfield (D) NC 1 Rep. Lloyd Doggett (D) TX 35 ELECTION GUIDE

Candidate State District Candidate State District Rep. Sean P. Duffy (R) WI 7 Rep. John Kline (R) MN 2 Rep. Renee Ellmers (R) NC 2 Sen. Amy Klobuchar (D) MN Rep. Jo Ann Emerson (R) MO 8 Rep. Thomas Latham (R) IA 3 Rep. Eliot L. Engel (D) NY 16 Rep. Sander M. Levin (D) MI 9 Rep. R. Blake Farenthold (R) TX 27 Rep. John R. Lewis (D) GA 5 Sen. Dianne Feinstein (D) CA Rep. David Loebsack (D) IA 2 Rep. Michael G. Fitzpatrick (R) PA 8 Mia Love (R) UT 4 Rep. Jeff Flake (R) AZ Rep. W. Blaine Luetkemeyer (R) MO 3 Rep. Virginia Foxx (R) NC 5 Rep. Daniel E. Lungren (R) CA 7 Rep. James W. Gerlach (R) PA 6 Sen. Joe Manchin, III (D) WV Rep. Christopher Gibson (R) NY 19 Rep. Thomas Marino (R) PA 10 Rep. Phil Gingrey (R) GA 11 Rep. Kevin McCarthy (R) CA 23 Rep. Charles A. Gonzalez (D) TX 20 Rep. Tom McClintock (R) CA 24 Rep. Robert Goodlatte (R) VA 6 Rep. Mike McIntyre (D) NC 7 Rep. Samuel B. Graves, Jr. (R) MO 6 Rep. Howard P. McKeon (R) CA 25 Rep. Tim Griffin (R) AR 2 Rep. David B. McKinley (R) WV 1 Rep. H. Morgan Griffith (R) VA 9 Rep. Cathy McMorris Rodgers (R) WA 5 Michelle Lujan Grisham (D) NM 1 Rep. Patrick L. Meehan (R) PA 7 Rep. S. Brett Guthrie (R) KY 2 Sen. Robert Menendez (D) NJ Sen. Orrin G. Hatch (R) UT Rep. Michael H. Michaud (D) ME 2 Rep. Nan Hayworth (R) NY 18 Rep. Timothy F. Murphy (R) PA 18 Rep. Joseph Heck, Jr. (R) NV 3 Rep. Richard Neal (D) MA 1 Sen. Dean Heller (R) NV Sen. Bill Nelson (D) FL Rep. Jaime Herrera Beutler (R) WA 3 Rep. Robert Neugebauer (R) TX 19 Rep. Maurice D. Hinchey (D) NY 19 Rep. Kristi Noem (R) SD 1 Rep. Ruben E. Hinojosa (D) TX 15 Rep. Richard B. Nugent (R) FL 11 Rep. Kathleen C. Hochul (D) NY 27 Rep. Devin G. Nunes (R) CA 22 Rep. Steny H. Hoyer (D) MD 5 Rep. Patrick Nunnelee (R) MS 1 Rep. Tim A. Huelskamp (R) KS 1 Rep. William L. Owens (D) NY 21 Rep. William P. Huizenga (R) MI 2 Rep. Frank Pallone, Jr. (D) NJ 6 Rep. Duncan D. Hunter (R) CA 50 Rep. Erik Paulsen (R) MN 3 Rep. Steve J. Israel (D) NY 3 Rep. Nancy Pelosi (D) CA 12 Rep. Darrell Issa (R) CA 49 Rep. Edwin G. Perlmutter (D) CO 7 Rep. Sheila Jackson Lee (D) TX 18 Scott Perry (R) PA 4 Rep. Lynn Jenkins (R) KS 2 Rep. Collin C. Peterson (D) MN 7 Rep. Henry C. Johnson, Jr. (D) GA 4 Rep. Thomas E. Petri (R) WI 6 Rep. Walter B. Jones (R) NC 3 Rep. Joseph R. Pitts (R) PA 16 Rep. James Jordan (R) OH 4 Jason Plummer (R) IL 12 Rep. Ron Kind (D) WI 3 Rep. Lloyd Poe (R) TX 2 Rep. Steven King (R) IA 4 Rep. Jared S. Polis (D) CO 2 Rep. Peter T. King (R) NY 2 Rep. Michael Pompeo (R) KS 4 Rep. Jack Kingston (R) GA 1 Rep. Bill Posey (R) FL 8 Rep. Adam Kinzinger (R) IL 16 Rep. Thomas E. Price, M.D. (R) GA 6 Rep. Lawrence Kissell (D) NC 8 Rep. Nick J. Rahall, II (D) WV 3 ELECTION GUIDE

Candidate State District Candidate State District Rep. Thomas W. Reed, II. (R) NY 23 Rep. Clifford B. Stearns (R) FL 3 Rep. Dennis Rehberg (R) MT 1 Tony Strickland (R) CA 26 Rep. David G. Reichert (R) WA 8 Rep. Betty Sutton (D) OH 16 Rep. Reid Ribble (R) WI 8 Rep. Lee Terry (R) NE 2 Rep. Edward Rigell (R) VA 2 Sen. Jon Tester (D) MT Rep. Martha Roby (R) AL 2 Rep. Glenn W. Thompson (R) PA 5 Rep. Michael Rogers (R) AL 3 Tommy G. Thompson (R) WI Rep. Mike Rogers (R) MI 8 Rep. Patrick J. Tiberi (R) OH 12 Rep. Peter J. Roskam (R) IL 6 Rep. Fredrick Upton (R) MI 6 Rep. Mike Ross (D) AR Rep. Chris Van Hollen (D) MD 8 Rep. Bobby L. Rush (D) IL 1 Ann L. Wagner (R) MO 2 Rep. Paul Ryan (R) WI 1 Rep. Timothy L. Walberg (R) MI 7 Matt Salmon (R) AZ 5 Rep. Greg P. Walden (R) OR 2 Rep. Janice D. Schakowsky (D) IL 9 Rep. Joe Walsh (R) IL 8 Rep. Adam B. Schiff (D) CA 28 Rep. Timothy J. Walz (D) MN 1 Rep. Aaron Schock (R) IL 18 Rep. Melvin L. Watt (D) NC 12 Rep. Allyson Y. Schwartz (D) PA 13 Rep. Henry A. Waxman (D) CA 33 Rep. Austin Scott (R) GA 8 Rep. Peter F. Welch (D) VT 1 Rep. Peter Sessions (R) TX 32 Brad Wenstrup (R) OH 2 Rep. John M. Shimkus (R) IL 15 Sen. Sheldon Whitehouse (D) RI Rep. Louise McIntosh Slaughter (D) NY 25 Rep. Edward Whitfield (R) KY 1 Rep. Adam Smith (D) WA 9 Sen. Roger Wicker (R) MS Rep. Lamar Smith (R) TX 21 Rep. Joe Wilson (R) SC 2 Rep. Steve Southerland (R) FL 2 Rep. Robert J. Wittman (R) VA 1 Sen. Deborah Stabenow (D) MI Rep. Kevin W. Yoder (R) KS 3 Rep. Fortney H. Pete Stark (D) CA 15 Rep. Todd Young (R) IN 9

VOTE We’ve been fighting for you in the halls of Congress, the courts, and state legislatures across the country. Many of you have made sacrifices to run for elected office, spent hours volunteering for -lo cal campaigns or have contributed to candidates. Even if you don’t have the resources or time to donate, the most important thing you can do is vote on or before November 6. CONTINUED SUPPORT OF NCPA PAC RAISES THE PROFILE OF INDEPENDENT COMMUNITY PHARMACY! To learn more about NCPA PAC, please contact Karry LaViolette at [email protected] or 703-600-1180.

“Are you willing to give a $1 a day [to the NCPA PAC] to protect your business and your bottom line?” —Steve Giroux, PAC Chairman, Middleport Family Health Center, Middleport, NY

Fold and return this form with your contribution to: NCPA PAC, 100 Daingerfield Rd., Alexandria VA 22314. For more information, contact: Karry LaViolette, Political Enrollment Form Development Director at 703.600.1180, 703.683.6375 fax, ❑ Yes! I want to protect my pharmacy by helping elect members of Congress who support community pharmacy! or email [email protected].

NAME NCPA MEMBER #

COMPANY NAME OCCUPATION

HOME ADDRESS CITY/STATE/ZIP

PHONE FAX EMAIL

❑ Enclosed is my personal check for a one-time donation, payable to “NCPA PAC”:  $5,000  $2,500  $1,000  $500  $365 (Dollar A Day)  Other $ ______(Partnership and sole proprietorship checks are permitted to PACs; however, corporate funds are prohibited by Federal law.)

❑ Please bill my personal credit card:  Visa  MasterCard  American Express  Discover

CARD # EXP. DATE

NAME ON CARD SIGNATURE TODAY’S DATE

With monthly contributions of:  $416.65 (maximum allowed)  $250  $100  $75  $50  Other $ ______Or, with a one-time contribution of:  $5,000 (maximum allowed)  $2,500  $1,000  $500  $365  Other $ ______

Contributions to the NCPA PAC are not deductible for federal income tax purposes. Contributions to NCPA PAC are used for political purposes. All contributions are voluntary. You may refuse to contribute without reprisal. The guidelines are merely suggestions; you may chose to contribute more or less than the guidelines suggest, and NCPA will not favor or disadvantage you by reason of the amount of your contribution or your decision not to contribute. Only U.S. Citizens (or those who have been lawfully admitted to permanent U.S. residence) are allowed to con- tribute to NCPA PAC. Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 in a calendar year. NCPAPAC-2012