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The 2018 Cycle AMPAC Election Report

A Note to AMPAC’s 2018 Contributors

The American Medical Association’s Political Action Committee (AMPAC) is grateful for members like you who generously supported the advocacy efforts of the American Medical Association (AMA) in 2018. Each year we strive to deliver a collective, unified voice for physicians in Washington, DC by supporting federal candidates who make medicine a priority.

In this election summary report, you will see how your support and that of your colleagues made a difference in our advocacy efforts, not only on issues that impact how you practice medicine but also to your patients. Without your help, these outcomes would not be possible. We thank you for your commitment to AMPAC this year, and hope we can count on your support again in 2019 as we continue working to advance the AMA’s advocacy efforts.

2018 AMPAC Political Activity

The 2018 elections presented AMPAC with a difficult political landscape to navigate. Health care was at the forefront of the national political debate and fierce battle lines were drawn between many Republicans advocating repeal of the Affordable Care Act which would reduce insurance coverage, versus Democrats proposing single payer or “Medicare for All” plans that would stifle delivery reform, reduce patient choice and threaten physician practice sustainability.

Because AMPAC remains bipartisan and is not a single-issue group, the challenge was working to find candidates who were not on the extreme end of their respective party’s spectrum. Solutions-oriented politicians who can compromise to make progress on complicated health care issues include more moderate Republicans who have moved on from the repeal ACA rhetoric and centrist Democrats who are not solely focused on enacting single-payer. Those lawmakers on both sides of the aisle who value the AMA’s guidance on issues impacting patient care have helped move the needle on timely issues including increased funding for NIH research, easing physicians’ administrative burdens and defending against threats of federal encroachment to the way states regulate the practice of medicine.

AMPAC incorporated valuable feedback from state medical society PACs and local physicians from around the country as it worked to identify candidates that would fit this mold and make for sound investments on behalf of organized medicine. In all, AMPAC contributed $1.4 million in the 2018 cycle that included direct contributions to 291 physician-friendly candidates for the U.S. House and Senate from both political parties (51% to Republicans and 49% to Democrats). These contributions provided more than 600 strategic opportunities for AMA lobbyists, physician leaders and local doctors to attend events and have important one-to-one interactions discussing issues critical to medicine. As the cost of elections continues to spiral ever higher, AMPAC is finding its value-add is our ability to create these opportunities.

Big-spending outside groups and dark money operations must remain independent and cannot have communications or interactions with candidates. Their heavy-hitting negative messaging is solely focused on affecting the outcome of elections in the current cycle and stands in stark contrast to AMPAC’s strategy of long-term relationship building with leaders in Congress, members of key committees and those lawmakers considered to be true champions of medicine.

From a broader perspective, a total of 250 AMPAC supported candidates won election/reelection. This included medicine’s top allies currently in Congress as well as a number of incoming freshmen that the AMA is eager to begin building relationships with and educating them on the issues that matter most to physicians. The total number of physicians in Congress also has increased, up from 13 to now 16. New physician members include John Joyce, MD (R, PA-13), Mark Green, MD (R, TN-7), and Kim Shrier, MD (D, WA-8).

2018 U.S. House of Representatives Summary

The 2018 midterm elections delivered majority control of the House of Representatives to the Democrats for the first time since 2010. As of this report, Democrats have gained 40 seats in the House – flipping 31 districts that President Trump carried in 2016. One additional race in NC-09 remains uncalled amid election fraud charges and may not be certified until 2019. While the sheer number of seats gained by Democrats was higher than initially expected, electoral history was always on their side. In all but two midterm elections since World War II, the party in the White House has lost congressional seats. This cycle saw a large number of GOP retirements coupled with historic grassroots fundraising and increased voter participation that ultimately handed Democrats a larger gain than in their previous wave elections of both 1982 and 2006.

Heading into the 2020 elections, another swarm of GOP retirements is expected as Members who were elected to office in the 2010 Republican wave have never served in a minority Congress and are not likely to enjoy the experience. Adding to the volatility will be a number of Democratic members abandoning their House posts in search of higher office. Even at this early stage, at least nine Democratic Senators are mulling a Presidential bid in addition to a host of Members of Congress who are exploring that possibility as well as bids for Senator or Governor. There is certain to be a lot of movement in Congress’ lower chamber.

2018 U.S. Senate Summary

Senate Republicans took advantage of Democrats being forced to defend 26 seats in November and were not only able to maintain control of the Senate, but pick up two seats and build a 53-47 majority. Democrats’ losses were concentrated overwhelmingly in deep-red states carried by President Trump in 2016. Republicans flipped seats in Missouri, Indiana, and North Dakota where popular Democratic incumbents failed to make a strong enough case to voters and were bested by challengers capitalizing on the popularity of the President.

And while the 2018 election cycle has just concluded, Republicans and Democrats alike are already prepping strategy for 2020. Republicans are now the ones who must play defense as they try to hold 22 of their seats that will be up to just 12 for Democrats. It is yet to be determined if President Trump’s popularity will take an upward or downward trajectory as we move into the second half of his term. As it stands now, political prognosticators aren’t betting on Democrats to flip the upper chamber. To do so, they will need to overcome the partisan lean of some fairly red states, plus successfully defend two seats of their own in Republican territory.

AMPAC Fundraising and Participation

AMPAC raised a combined $2.2 million dollars in hard and corporate receipts during the 2018 election cycle, with hard dollars representing 88% of overall receipts. AMPAC’s hard dollar receipts are used for direct candidate contributions or independent expenditures. As in previous election years, AMPAC’s Capitol Club played an important role in AMPAC’s overall fundraising efforts and was instrumental in bolstering receipts this cycle. We thank those who stepped up with your generous support at these higher levels of giving. Capitol Club ended 2018 with 902 members and nearly eclipsed 2014’s all-time Capitol Club participation record of 909 members. 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 grow with an exceptional 80% of House of Delegate members participating in AMPAC, the highest participation rate on record.

With the 2020 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

2018 was another landmark election in terms of physician candidates with over 70 physicians running for federal office at one point during the cycle. In 2019, AMPAC will once again host the Candidate Workshop to help AMA members become more effective advocates for medicine. The Candidate Workshop will be held March 1-3 at the AMA offices in Washington, DC. Enrollment for this program 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 workshop are covered by AMPAC. Participants are responsible for the registration fee, hotel accommodations and travel to and from Washington, DC. For more information, please 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.