2016 Post-Election Update Analysis of 2016 Elections

PRESIDENTIAL Americans fed up with eight years of a slug- gish economy and a growing discontent with their lead- ers in Washington voted to send businessman and political novice to the White House, guaranteeing one of the biggest shakeups in political history. Trump was successful in winning the key states of Florida, Georgia, Iowa, Michigan, North Carolina, Ohio, , and Wisconsin to de- feat former first lady, former senator, and former Secretary of State Hillary Majority Leader: Sen. Mitch McConnell Policy Committee Chair: Clinton with 306 electoral votes to (R-KY) Sen. Debbie Stabenow (D-MI) 232. Clinton had been seeking to Majority Whip: Sen. John Cornyn (R-TX) Policy Committee Vice Chair: make history as the first woman to Conference Chairman: Sen. John Sen. (D-WV) win the White House, but instead Thune (R-SD) Conference Vice Chairs: Sen. the 70-year-old Trump made history Conference Vice Chair: Sen. Roy Elizabeth Warren (D-MA) and Mark of another sort, becoming the first Blunt (R-MO) Warner (D-VA) person elected to the top job without Policy Committee Chair: Sen. John DSCC Chairman: Sen. Chris Van having held a high government Barrasso (R-WY) Hollen (D-MD) office or military command. NRSC Chair: Sen. Cory Gardner (R-CO) Key Committees Finance: Sen. (R-UT), SENATE Democratic Leadership chairman; Sen. Ron Wyden (D-OR), Republicans held on to Senate Democrats held leadership ranking member. the majority in the Senate elections, placing some familiar faces Health, Education, Labor and Pen- where they were defending in new roles within the caucus. New sions (HELP): Sen. Lamar Alexander 10 seats vs. 24 Democratic seats. The York’s Senator Chuck Schumer will (R-TN) chairman; Sen. Patty Murray new Senate line-up will be comprised take the helm as Minority Leader, a (D-WA), ranking member. of 52 Republicans and 48 Democrats, position vacated by Harry Reid (D- including two Independents expected NV) following his retirement at the to caucus with the Democrats. end of the 114th Congress. HOUSE OF REPRESENTATIVES Minority Leader: Sen. Charles All 435 seats in the House The NCPA PAC contributed to 15 Schumer (D-NY) were up for grabs and the Senate candidates this election Minority Whip: Sen. Dick Durbin Republicans continued in control, win- cycle with 15 (100%) winning. (D-IL) ning 241 seats to 194 for the Democrats. Assistant Leader: Sen. Patty Murray Republican Leadership (D-WA) The NCPA PAC contributed to 160 Senate Leadership team in the 115th Conference Chair: Sen. Tammy House candidates this election Congress will largely remain the same. Baldwin (D-WI) cycle with 148 (92.5%) winning.

2 2016 Post-Election Update Republican Leadership DCCC Chairman: Rep. Ben Ray Luján will maintain a similar level of control Familiar faces were elected to the Re- (D-NM) in a year when many expected Demo- publican House Leadership. Pharmacy crats to net seats and chambers. champion Rep. Doug Collins of Georgia Key Committees was successful in his bid for a GOP Energy and Commerce: Rep. Greg Three chambers switched from Demo- leadership position and was elected Walden (R-OR-2), chairman; Rep. cratic to Republican control: Kentucky House Republican Conference vice chair. Frank Pallone (D-NJ-6), ranking House, Iowa Senate, and Minnesota The conference is the party caucus in the member. Senate. While four chambers switched House and responsible for electing the Ways and Means: Rep. Kevin Brady from Republican to Democratic Republican leadership, approving GOP (R-TX-8), chairman; Rep. Richard control: New Mexico House, Nevada member committee assignments, and Neal (D-MA-1), ranking member. Assembly, and Nevada Senate. In developing communications strategy. the Washington Senate, Republicans, The conference is chaired by another however, will have functional control committed champion of independent In the States as one Democrat will caucus with the community pharmacy, Rep. Cathy Mc- GOVERNORS Republicans. Lastly, one chamber will Morris Rodgers of Washington. Despite an aggressive financial push be tied: Connecticut Senate. from Democrats, Republicans cement- Speaker of the House: Rep. Paul ed their dominance of the nation’s Community pharmacy was victorious Ryan (R-WI) 12 gubernatorial races, ending with on the state level where there will be Majority Leader: Rep. Kevin McCarthy their highest number of governorships 43 pharmacists (36 Republicans and (R-CA) since 1922. seven Democrats) serving in state leg- Majority Whip: Rep. Steve Scalise (R-LA) islatures, consisting of reelected and Conference Chair: Rep. Cathy The GOP flipped control of gover- new and legislators in 24 states. Of McMorris Rodgers (R-WA) nors in Missouri, Vermont, and New the 24 incumbent races, all seats were NRCC Chairman: Rep. Steve Stivers Hampshire. That means the party retained. Of the three races with new (R-OH) will hold the governors’ offices in 33 pharmacist candidates, all won. Policy Committee Chairman: states, up from 31. In a shocking night Rep. Luke Messer (R-IN) for Democrats on the national stage, The NCPA PAC contributed to 4 Conference Vice-Chair: Rep. Doug these additional losses pushed the State candidates this election Collins (R-GA) party further into the political wilder- cycle with 2 (50%) winning. Conference Secretary: Rep. Jason ness in the states, where they have Smith (R-MO) been struggling to compete for years. Alabama: The following were not up: Democratic Leadership Just three seats were considered safe Sen. Billy Beasley (D), Rep. Elaine Beech Like the GOP, Democrats returned for Democrats, who had to defend (D), and Rep. Ronald Johnson (R). many of the same figures to leadership governorships in five of the seven most Arkansas: Rep. Justin Boyd (R) was positions. competitive races, including contests reelected. in states Obama lost in 2012 that California: Sen. Jeff Stone (R) was Minority Leader: Rep. Nancy Pelosi Donald Trump would go on to win: not up. (D-CA) West Virginia, Montana, and Missouri. Georgia: Rep. Bruce L. Broadrick (R), Minority Whip: Rep. Steny Hoyer Rep. Buddy Harden (R), Rep. Butch (D-MD) LEGISLATURES Parrish (R), and Rep. Ron Stephens (R) Assistant Minority Leader: Rep. Jim While things were certainly memorable were reelected. Clyburn (D-SC) at the top of the ticket, state legislative Idaho: Rep. Susan B. Chew (D) was Democratic Caucus Chair: races also made their mark. Overall, reelected. Rep. Joseph Crowley (D-NY) Republicans bested expectations. Indiana: Rep. Steve Davisson (R) was Democratic Caucus Vice Chair: Having already reached the peak of reelected. Rep. Linda Sanchez (D-CA) control in party history, Republicans Iowa: Rep. John Forbes (D) was

3 reelected. New candidate Sen. Tom BALLOT INITIATIVES Greene (R) was elected. Voters in California rejected Propo- Kansas: Sen. Vicki Schmidt (R) was sition 61, which would have capped reelected. how much the state’s public health Kentucky: New candidate Rep. Danny programs pay for medicines at the Bentley (R) was elected. same level the U.S. Department Louisiana: The following were not up: of Veterans Affairs (which receives Sen. Fred Mills (R), Rep. H. Bernard deep discounts). The measure failed LeBas (R), and Sen. Ronnie Johns (R). 46%-54%. Rep. Tom Reed (R-NY-23) meets with Maine: Rep. Robert W. Nutting (R) NCPA members in Olean, N.Y. did not seek reelection due to the 2016 Pharmacy Visits state’s term limits. Rep. Paul Chace (R) was reelected. Independent pharmacists face some Maryland: Del. Theodore J. Sopho- critical challenges, and NCPA Govern- cleus (D) was not up. ment Affairs staff works tirelessly on their Mississippi: The following were not behalf to promote common sense solu- up: Rep. Bobby B. Howell (R), Rep. tions. While NCPA can provide broad Eugene Forrest Hamilton (R), Rep. information, legislators want to know John Read (R), and Rep. H. Nolan how do these issues affect independent Mettetal (R). pharmacies in my district. An effective Missouri: Sen. David Sater (R), Rep. way to answer this question is to host Rep. Bradley Byrne (R-AL-1) meets with Keith Frederick (R), and Rep. Lynn Mor- your legislator for a visit and tour of your NCPA members in Mobile, Ala. ris (R) were reelected. New candidate pharmacy or to meet with them face-to- Rep. Mike Stephens (R) was elected. face in their district offices. Such meet- New York: Assemblyman John Mc- ings help localize complex issues such as Donald, III (D) was reelected. opaque DIR fees and MAC prices that North Dakota: Sen. Howard C. far too often leave independent pharma- Anderson Jr. (R) was reelected. cies underpaid for their services. Ohio: Sen. Dave Burke (R) was reelected. Oklahoma: Rep. David Derby (R) and Additionally, a pharmacy tour has the Sen. Rob Standridge (R) were reelected. added benefit of providing a legislator Oregon: Rep. Mitch Greenlick (D) a “behind the scenes” look at daily was reelected. operations and illustrate the important Rep. Rod Blum (R-IA-1) meets with NCPA South Carolina: Sen. Kevin L. Bryant role independent pharmacies play in members and staff in Cedar Falls, Iowa. (R), Rep. L. Kit Spires (R), and Sen. Ronnie W. Cromer (R) were reelected. Tennessee: Sen. Ferrell Haile (R) was reelected. Sen. Randy McNally (R) was not up. Texas: Sen. Charles Schwertner (R) was not up. Utah: Sen. Evan Vickers (R) was not up. Virginia: The following were not up: Del. Chris Jones (R) and Del. M. Keith Hodges (R). Washington: Sen. Linda Evans Parlette (R) retired. Rep. Mike Pompeo (R-KS-4) visits El Dorado TrueCare Pharmacy in El Dorado, Kan.

4 2016 Post-Election Update the community and the overall health care system. When visiting a pharma- cy, elected officials have hands-on opportunity to speak with the hosting pharmacies, the staff, and his or her constituents who visit the pharmacy.

NCPA members held over 80 pharmacy visits or face-to-face meetings with mem- bers of Congress in 2015-2016. Some of these visits were highlighted in several posts on NCPA’s blog The Dose and in America’s Pharmacist. If you are interest- ed in hosting your member of Congress for a pharmacy visit, please contact Ken- dal Ann Miller in the NCPA Government Rep. Bill Posey (R-FL-8) meets with Florida pharmacists in Merritt Island, Fla. Affairs Department at 703-838-2695. Medically Underserved Enhancement Pharmacy Fundraisers Act), and any willing pharmacy (H.R. Grassroots: 793; S. 1190, the Ensuring Seniors For Key Members Of NCPA Members Access to Local Pharmacies Act). Congress Grassroots contacts from independent Actively Engage pharmacists helped increase support In the 2015-2016 election cycle, With Congress significantly for each of these measures. NCPA organized a number of highly successful fundraisers. Many NCPA 2015-2016 were busy years for NCPA NCPA has also continued grassroots ef- members made personal contribu- grassroots efforts. NCPA Government forts at the state level. We have assisted tions, and NCPA hosted industrywide Affairs staff worked diligently with several states with grassroots outreach political action committee (PAC) Senate and House offices to address on issues such as pharmacy audits, events. These events raised over retroactive DIR fees. That effort re- MAC pricing updates, and anti-man- $500,000. sulted in legislation being introduced, datory mail order (AMMO) legislation. (H.R. 5951 and S. 3308, Improving We also urged opposition to a proposal Senate Transparency and Accuracy in Medi- in Connecticut that would impose a • Sen. Chuck Grassley (R-IA) care Part D Spending Act) in both surcharge on controlled substances. • Sen. Jerry Moran (R-KS) chambers of Congress. In a little over two months, NCPA members sent more With the incoming Trump administra- House than 10,000 email messages to their tion and the Republican congressional • Rep. Rod Blum (R-IA-1) legislators urging support for this crit- majorities, 2017 is likely to be one of • Rep. Kevin Brady (R-TX-8) ical measure. Thanks to these efforts, legislative action. We expect bills will • Rep. Buddy Carter (R-GA-1) the legislation received the support of again be introduced to address DIR • Rep. Doug Collins (R-GA-9) 35 cosponsors in the House and eight fees, MAC transparency, and provider • Rep. Morgan Griffith (R-VA-9) in the Senate. status. The groundwork laid in the 114th • Rep. Brett Guthrie (R-KY-2) Congress puts independent pharmacy • Rep. Ron Kind (D-WI-3) Additionally, legislation was once again in a strong position headed into 2017. • Rep. Dave Loebsack (D-IA-2) introduced to address MAC transpar- However, it is imperative that inde- • Rep. Tom Marino (R-PA-10) ency (H.R. 244, the MAC Transparency pendent pharmacists remain actively • Rep. Martha Roby (R-AL-2) Act), provider status for pharmacists involved in grassroots efforts if we are to • Rep. Cathy McMorris Rodgers (H.R. 592; S. 314, the Pharmacy and continue to make legislative progress. (R-WA-5)

5 • Rep. Frank Pallone (D-NJ-6) • Tony Ogden, Groveway Pharmacy 2016 LDF GOLD DONORS • Rep. Collin Peterson (D-MN-7) • Bill Osborn, Osborn Drugs, Inc. ($50,000 OR MORE ANNUALLY) • Rep. Terry Sewell (D-AL-7) • Independent Pharmacy Cooperative • Rep. Austin Scott (R-GA-8) 2016 NCPA PAC CHAMPIONS • McKesson Corporation • Rep. Peter Welch (D-VT-AL) ($2,500 OR MORE PERSONAL • Professional Compounding Centers CONTRIBUTION) of America • Michael Butler, Village Health Mart • Rochester Drug Cooperative, Inc. Drug • Jeff Harrell, Illwaco Drugs 2016 LDF SILVER DONORS ($5,000 • Sherwood Klein, Ellicottville Pharmacy, OR MORE IN CORPORATE FUNDS The NCPA PAC is a way to ensure that Inc. ANNUALLY) our industry speaks with one voice in • Lonnie Meredith, The Drug Store • Alliance of Independent Pharmacies Washington, D.C., and has a power- • William Moore, Moore’s Pharmacy of Texas ful political presence in the nation’s • Anthony Ortiz, Atlas Drug and • American Pharmacy Services capital. In the current election cycle Nutrition Corporation (Jan. 1, 2015–Dec. 31, 2016), the • Darrin Silbaugh, Harrisburg Pharmacy • Georgia Academy of Independent NCPA PAC contributed $750,000 to • Troy Simons, Foster Corner Drug Pharmacy candidates and party committees at • Dave Smith, Retired • H. D. Smith the federal level. Thank you to all who • Mike Vinson, Adams Drug • Northeast Pharmacy Services generously contributed with personal • Lonny Wilson, Pharmacy Providers Corporation funds to the NCPA PAC. Without your of Oklahoma • PBA Health support we would have not been able • RJRX, Inc./ Denver Drug, Inc. to support so many successful candi- • RxPlus Pharmacies, Inc. dates this election cycle!

2016 NCPA PAC MVPS ($5,000 MAXIMUM PERSONAL CONTRI- BUTION ALLOWED BY LAW) The NCPA Legislative/Legal Defense • Bradley Arthur, Black Rock Pharmacy Fund (LDF) supports NCPA’s ongoing • Shelley Bailey, Central Drugs political advocacy initiatives includ- • Jay Blackburn, Compliant Pharmacy ing lobbying activities, research, Alliance coalition-building, grassroots mo- NCPA STUDENT CHAPTERS THAT • Jeff Carson, Oakdell Pharmacy bilizations, targeted advertisement, HAVE CONTRIBUTED TO THE • John Carson, Oakdell Pharmacy and lawsuits in the states. Govern- NCPA LDF OR NCPA PAC IN 2016 • Brian Caswell, Wolkar Drug, Inc. ment controls more and more of our • Auburn University • Hugh Chancy, Chancy Drugs business and NCPA battles to ensure • Eastern Tennessee State University • Charles Cottrell, Medical Center your ability to grow your business and • Ohio Northern University Pharmacy serve your patients. The LDF is our • University of Arkansas • Arthur Ennis, Jr., Payless Drugs war chest in the fight. All of our suc- • University of Iowa • Stephen Giroux, Middleport Family cess—this year and into the future— • Washington State University Health Center depends on your support. • Robert Greenwood, Greenwood We would also like to thank the 16 Drug, Inc. 2016 LDF PLATINUM DONORS student volunteers that made our PAC • H. Edward Heckman, PAAS National ($200,000 OR MORE ANNUALLY) telethons in March and May successes! • B. Douglas Hoey, National Community • AmerisourceBergen Pharmacists Association • • Edmund Horton, Tanglewood • Compliant Pharmacy Alliance Pharmacy Cooperative

6 2016 Post-Election Update CONTINUED SUPPORT OF NCPA PAC RAISES THE PROFILE OF INDEPENDENT COMMUNITY PHARMACY! To learn more about NCPA PAC, please contact Kendal Ann Miller at [email protected] or 703-838-2695.

“Are you willing to give $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. Enrollment Form For more information, contact: Kendal Ann Miller, PAC Manager at 703-838-2695, 703-683-6375 fax, or ❑ Yes! I want to protect my pharmacy by helping elect members of Congress who support community pharmacy! email [email protected].

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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-2017