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The 2016 Cycle AMPAC Election Report

A Note to AMPAC’s 2016 Contributors

The American Medical Association’s Political Action Committee (AMPAC) is truly grateful for members like you who generously support the advocacy efforts of the American Medical Association (AMA). Each year we strive to deliver a collective, unified voice for physicians in Washington by supporting federal candidates who make medicine a priority.

We hope you will review the content of the 2016 Election Summary with the knowledge that without your help, these outcomes would not be possible. We thank you for your commitment to AMPAC, and hope you will continue to support the AMA’s advocacy efforts in the coming years.

2016 Elections

AMPAC played an important role in influencing 2016 election outcomes on behalf of medicine. Working together with state medical society PACs, AMPAC invested nearly $2 million in the 2016 cycle. This included direct contributions to 348 physician-friendly candidates for the U.S. House and Senate from both political parties (61% to Republican lawmakers and 39% to Democratic lawmakers). A total of 314 AMPAC supported candidates won election/reelection and AMPAC’s total win rate in the 2016 cycle was 91%. The total number of physicians in Congress has dipped from 17 and now stands at 14 (soon to be 13 with the recent announcement that Rep. Tom Price, MD will be appointed to Secretary of the Health and Human Services Department). This is due mainly to retirements and physician incumbents seeking other office.

AMPAC also executed four independent expenditure (IE) campaigns on behalf of physician candidates: Neal Dunn, MD (R, FL-02), Roger Marshall, MD (R, KS-01) and Rep. Joe Heck, DO (R, NV-SEN), and incumbent Rep. Ami Bera, MD (D, CA-07). Unlike in years past when AMPAC has focused IEs on broader “get out the vote” efforts, the goal in these races was to help them raise much needed campaign funds through an integrated mail and email solicitation program that reached over 56,000 physicians in all. After bruising primary contests, both Dr. Dunn and Dr. Marshall had clear paths to victory on November 8. Both, however, had incurred significant primary debt that must be addressed quickly to prevent them from beginning the 2018 election cycle at a disadvantage. Doctors Bera and Heck were in two of the most tightly contested races in the country and needed every additional dollar possible in order to keep their campaign machinery running at top speed through the election.

Contributions were sent directly to the campaigns in order to insure that they were received in the quickest and most efficient manner possible. This process made it difficult to track exactly how much was raised. However, AMPAC will be conducting a more thorough analysis once the campaigns have submitted their final reports to the FEC.

This fundraising IE program was an experimental pilot project and it is very possible that the end result may not reveal significant benefits for the campaigns that AMPAC supported. It should still be viewed as a worthwhile endeavor as AMPAC continues to test new IE strategies capable of having a real impact in an evolving political landscape that continues to grow exponentially more expensive. Strictly from a win/loss perspective however, the AMPAC IE program went three-for-four in 2016 as Dunn, Marshall and Bera all emerged victorious, while Heck ended up losing in one of the closer Senate races this cycle.

2016 Federal Elections Update

To say 2016 was an unusual election year is indeed an understatement. Larger than life candidates at the top of the ticket scrambled conventional wisdom in the race for the White House as well as contests down ballot. The following is an overview of the national political environment in the wake of the 2016 Presidential and Congressional midterm elections:


The 2016 Presidential election was unconventional for both parties. Whether it was a reality TV star new to politics taking Republicans by storm or an elderly, socialist Senator energizing youth on the Democratic side, “the traditional rules” of campaigns were thrown out.

The Republican primaries were especially chaotic. Several Republican candidates fit the model of past success – good fundraising, successful records as Governors, ideologically correct messages. But in 2016, none of that mattered. Republican primary voters were ready for something different. They eschewed the Republican establishment and embraced Donald Trump.

Trump, for all of his flaws as a candidate, understood two things: he had the ability to command media focus, starving his opponents of attention and he correctly sensed that people were ready for change at the top of the Republican Party.

On the Democratic side, there were a few hiccups on the way to a Hillary Clinton coronation. The rise of Bernie Sanders foreshadowed Clinton’s general election problems in motivating and mobilizing both the younger and more progressive wings of the Democratic Party. Additionally, she attempted to adopt an identity politics campaign that emphasized her quest to be the first female president, rather than an issue-based campaign.

Even the most casual of political observers are familiar with the twists and turns of the general election. Trump suffered from many self-inflicted wounds and, yet, never fell too far behind Clinton. In retrospect, his resiliency showed that his supporters were not deterred by negative campaigning against him and that many of his voters had ruled out voting for Clinton from the very beginning.

Trump meanwhile managed to do the nearly impossible, perform better than McCain and Romney among women, African-Americans and Hispanics while holding most mainstream Republicans. His unique coalition broke through the supposed Democratic “Electoral College Lock” by flipping several Obama states including Florida, North Carolina, Pennsylvania, Michigan and Wisconsin. The final electoral count (306 to 232) was a comfortable victory.

Of course, President-elect Trump also lost the popular vote. This is a powerful talking point for his opponents. But, it is important to note, that if the highest popular vote was the goal, both campaigns would have mounted very different campaigns.

Whether House and Senate Republicans and President Trump can lock-in these gains for 2018, 2020 and beyond is dependent on how they govern with control of both the executive and legislative branches. So far, there has been abundant talk in conservative circles of unity and shared goals. Only time will tell however, if this is more than mere rhetoric and if the President and the Republican majority in both chambers of Congress can indeed form an effective governing coalition.

United States Senate (34 contested seats)

Despite having to defend 24 seats in November, Republicans were able to limit their loses to two seats and maintain control of the Senate. This outcome, however, was unexpected. Senate Republicans found themselves trailing considerably in multiple key battleground states several weeks from Election Day, and many political prognosticators predicted a Democratic-controlled Senate to be a forgone conclusion. Looking back now it appears evident that Donald Trump had a significant effect on certain down ballot races and is partly responsible to buoying several fledgling campaigns and ensuring that Republicans remained in the majority.

U.S. House of Representatives (435 contested seats)

After achieving the largest majority in generations following the 2014 election, House Republicans were faced with the difficult task of defending 247 seats in an open seat Presidential Election. While few thought that another “political wave” would hit the House and sweep Democrats into power, it was widely believed that the GOP would suffer significant loses and Democrats would gain anywhere from 10 to 20 seats. Much of this relied on the theory that Trump would hurt Republicans in moderate districts and those with high Latino populations. This anticipated down-ballot drag turned out to be a mirage and Democrats managed a meager pick-up gain of 6 seats.

Looking Ahead to the 2018 Election Cycle

U.S. House of Representatives (435 contested seats)

In the House meanwhile, Congressional Districts remain fairly entrenched. Ten Republicans reside in districts won by Hillary Clinton in 2016, but eight Democrats represent districts that went for Donald Trump. Typically the party that holds the White House ends up losing seats in Congress in midterm elections. But while Democrats may indeed gain ground, it is doubtful they would win enough seats to flip control absent a significant outside event that would trigger some kind of political wave. Another important factor to consider is that with the prospect of Democrats remaining in the minority for the next two years and more likely the next four, a wave of retirement announcements from veteran Democratic members would not come as a total shock.

United States Senate (32 contested seats)

The 2016 Election Cycle has just concluded, but Republicans and Democrats alike are already prepping strategy for 2018. On the Senate side, the dynamic has flipped. Republicans were on defense in 2016, with 24 seats to just 10 for Democrats. In 2018 however, it will Democrats’ turn as they seek to hold 24 of their seats that will be up to just eight for Republicans.

As 2018 is a midterm election, Democrats can take some solace in the conventional wisdom that the party in power (Republicans) generally loses seats. But the exposure for the GOP is limited and only two of their eight seats look to be in question as of now: Nevada with Sen. Dean Heller due to the fact that Obama carried the state in 2012 and Clinton won it in 2016; and Arizona with Sen. Jeff Flake, who has already drawn a primary opponent and has issues with the GOP base for opposing Trump.

Here is an early look at Charlie Cook’s 2018 Senate Race Ratings:

Democrats: 25 Held Seats
Solid D: Feinstein (CA); Murphy (CT); Carper (DE); Hirono (HI); Cardin (MD); Warren (MA); Klobuchar (MN); Heinrich (NM); Gillibrand (NY); Whitehouse (RI); Sanders (VT-I); and Cantwell (WA)
Likely D: Menendez (NJ); Stabenow (MI); Casey (PA); Tester (MT); Heitkamp (ND); Manchin (WV); Baldwin (WI); and Kaine (VA)
Lean D: Nelson (FL); Donnelly (IN); King (ME-I); McCaskill (MO); and Brown (OH)

Republicans: 8 Held Seats
Solid R: Wicker (MS); Fischer (NE); Corker (TN); Cruz (TX); Hatch (UT); and Barrasso (WY)
Lean R: Flake (AZ) and Heller (NV)

AMPAC Fundraising and Participation

During the 2016 election cycle, AMPAC receipts totaled over $2.4 million dollars, which is considered robust given the tumultuous nature of this election season. AMPAC’s hard dollar receipts are used for direct candidate contributions or independent expenditures.

AMPAC’s Capitol Club major donor program continued to trend upward and remained fundamental in driving AMPAC receipts this cycle. We saw steady growth in AMPAC’s Capitol Club program with 891 members. In particular, AMPAC’s Capitol Club Platinum participation advanced to an all-time high of 80 members, which was an 11% increase over last year. Capitol Club members participate at one of the following levels: Capitol Club Platinum ($2,500 annually), Gold ($1,000 annually) or Silver ($500 annually). AMPAC participation in the AMA’s House of Delegates (HOD) continued to progress with an exceptional 78% of House of Delegate members participating in AMPAC, the largest participation rate on record.

With the next election cycle before us, your participation in AMPAC is more important than ever. We urge you to renew your commitment to AMPAC early so we can continue supporting and electing physician-friendly candidates to Congress. To join or find out more, please visit our website at www.ampaconline.org, or contact AMPAC’s Washington office at (202) 789-7400.

AMPAC Political Education Programs

2016 was another landmark election in terms of physician candidates with 52 physicians running for federal office at one point during the cycle. The total number of physicians in Congress dipped from 17 to 14 due to retirements and physician incumbents seeking other office. Despite the decline in numbers, the 115th Congress will welcome two new physician members: Representative-elects Neal Dunn (R-FL) and Roger Marshall (R-KS) who both cruised to victory after winning contested primaries.

AMPAC Political Education Programs alumnus Rep. Tom Price, MD (R-GA) was recently announced as President-elect Trump’s nominee for Secretary of the Health and Human Services Department. He is expected to win confirmation to head the federal agency with direct oversight over health care delivery.

In 2017, AMPAC will once again host the Candidate Workshop to help AMA members become more effective advocates for medicine. The Candidate Workshop will be held February 17-19 at the AMA offices in Washington, DC. Enrollment is open now and AMA members, their spouses and immediate family members, and Federation staff receive priority consideration. Faculty, materials and all meals during the meeting are covered by AMPAC. Participants are responsible for the registration fee, hotel accommodations and travel to and from Washington, DC. For more information, visit http://www.ampaconline.org/political-education/


AMPAC is a separate segregated fund established by the AMA. Voluntary political contributions by individuals to AMPAC should be written on personal checks. Funds from corporations cannot be used for contributions and expenditures in Federal elections. Corporate contributions will be placed in a separate AMA account for political education and other non-election activities. Contributions are not limited to the suggested amount. Neither AMA nor its constituent state associations will favor or disadvantage anyone based upon the amounts of or failure to make PAC contributions. Voluntary political contributions are subject to limitations of the FEC regulations. Contributions to AMPAC are not deductible for federal income tax purposes.