State Legislative Conference 2016

1. 2016 Election Update
Mark Cribben, JD
Director FamMedPAC
Manager Grassroots

2. State of the Presidential Race
While the President has seen his approval ratings rise, boding
well for Clinton, most still believe that the nation is on the
wrong track, giving hope to Donald Trump’s campaign.
Hillary Clinton took the lead over Donald Trump
around Memorial Day, however both candidates
continue to be among the least favorable candidates in
history.
General Election Polling
Clinton
Trump
48.5% 42.2%
51.5%
“All in all, do you think things in the nation are
generally headed in the right direction, or do you feel
things are on the wrong track?”
■ Right Direction ■ Wrong Track
President Obama has seen his
approval ratings consistently rise
since Christmas 2015. In December his
approval rating was averaging at about
43%.
Presidential Approval Rating
29.2
64.7
0
10
20
30
40
50
60
70
Right Direction
Wrong Track

3. WHO WILL WIN THE
PRESIDENCY?
Polls-plus forecast
Hillary Clinton: 83.5% Donald Trump: 16.4%
Polls-only forecast
Hillary Clinton: 86.2% Donald Trump: 13.8%
Now-cast
Hillary Clinton: 86.5% Donald Trump: 13.5%
projects.fivethirtyeight.com

4. Presidential Battleground States

6. 6
2016: Enormous Stakes for Healthcare
If Clinton Wins:
• Gridlock; R’s likely to keep House
• ACA protected from repeal by veto
• Passing “fixes” to ACA also unlikely
• Crack down on drug price increases
If Trump Wins:
• Republicans keep House & Senate
• ACA repeal through reconciliation?
• GOP may not agree on replacement
• Leave Medicaid expansion to states
• Reduce barriers to entry for new
pharma

7. Presidential candidates’ health care stances
generally adhere to respective party lines
Sources: The Briefing, "Hillary Clinton's Plan for Lowering Out-of-Pocket Health Care Costs", HillaryClinton.com, September 23, 2015; Dylan Scott, "Explaining Hillary Clinton's Trip to the Health Policy Twilight Zone," National Journal, April 21, 2015; "Healthcare Reform to Make
America Great Again," DonaldJTrump.com, May 19, 2016; "Affordable Health Care is a Basic Human Right", HillaryClinton.com, May 19, 2016; "Bernie Sanders on Healthcare," FeeltheBern.org, May 19, 2016; Rachel Witkin, "Where 2016 Candidates Stand on Mental Health
Issues" NBC News, February 24, 2016; Julie Edgar, “Health Care Reform: Health Insurance & Affordable Care Act,” WebMD, May 20, 2016; "Annotated Transcript: The Aug. 6 GOP Debate", Washington Post, August 6, 2015.
Affordable Care Act Single-Payer Medicare Medicaid Abortion
 Keep   Expand  Expand Supports
 Replace   Keep  Keep  Ban
Overview of candidates’ stances on major health care legislation
Hillary Clinton
Donald Trump

8. Presidential candidates’ stances on health policy
span political spectrum
Sources: The Briefing, "Hillary Clinton's Plan for Lowering Out-of-Pocket Health Care Costs", HillaryClinton.com, September 23, 2015; Dylan Scott, "Explaining Hillary Clinton's Trip to the Health Policy Twilight Zone," National Journal, April 21, 2015; "Healthcare Reform to Make
America Great Again," DonaldJTrump.com, May 19, 2016; "Affordable Health Care is a Basic Human Right", HillaryClinton.com, May 19, 2016; "Bernie Sanders on Healthcare," FeeltheBern.org, May 19, 2016; Rachel Witkin, "Where 2016 Candidates Stand on Mental Health Issues"
NBC News, February 24, 2016; Alan Rappeport and Margot Sanger-Katz, "Hillary Clinton Takes a Step to the Left on Health Care," New York Times, May 10, 2016.
Health Care Program Clinton Trump
Affordable Care Act (ACA)  Preserve & Build  Repeal & Replace
Prescription Drug Prices  Control drug prices & hold drug companies accountable. 
Lower barriers to trade to allow drug makers from overseas to
sell in the U.S.
Medicaid Expansion  Support new incentives to encourage states to expand ? Unclear, Trump proposes state block-grants for Medicaid
Medicare Buy-In 
Supports people 50+ to be able to purchase Medicare
coverage ?
Unknown, Trump promised to improve Medicare by making
“the country rich”
Public Option  Supports public option, suggests state initiatives under ACA  Does not support
Mental Health Parity  Wants mental health parity with physical health issues  Supports current reform plan in Congress
Provider Price Transparency  Would expand disclosure requirements  Require transparency from doctors and hospitals
Sale of Health Insurance Across State Lines ?
Early 2015 Clinton expressed an open mind, not currently in
her platform  Allow health insurance to be sold across state lines
Details on 2016 presidential candidates’ platforms on health care

9. 9

10. 10
Breakdown of 2016 Senate Races
Cook Political Report Rating
Republicans defending 24 seats, seven in states that Obama carried in 2012
7 of 24 Republican Senate Seats
Considered Toss Up This Cycle
Rubio (FL)
Kirk (IL)
IN (Coats)
Ayotte (NH)
Portman (OH)
Toomey (PA)
Johnson (WI)
1 of 10 Democratic Senate Seats
Considered a Toss Up This Cycle
NV (Reid)

11. 11
24
8
22
10
24
11
2016 2018 2020
Democrats, Republicans Will Take Turns Playing
Defense in Elections Ahead
Senate Seats in Play, by Election Year
■ Republican Seats ■ Democratic Seats

12. 12
FLORIDA
Presidential
FiveThirtyEight: Clinton 74.5% Trump 25.5%
RCP Average: Clinton +3.8
Sen. Marco Rubio (R) Incumbent
Rep. Patrick Murphy (D)
Senate Race
RCP: Toss Up; Rubio +4.8
Cook: Toss Up
FiveThirtyEight: Rubio has 75.4% chance of winning

13. 13
ILLINOIS
Presidential
FiveThirtyEight: Clinton 99.1% Trump 0.9%
RCP Average: Clinton +15
Senate Race
RCP: Leans Dem; Duckworth +7
Cook: Lean D
FiveThirtyEight: Duckworth has 88.9% chance of winning
Sen. Mark Kirk (R)
Incumbent
Rep. Tammy Duckworth (D)

14. 14
INDIANA
Senate Race
RCP: Toss Up; Bayh +4.3
Cook: Toss Up
FiveThirtyEight: Bayh has a 69% chance of winning
Presidential
FiveThirtyEight: Clinton 15.3% Trump 84.6%
RCP Average: Trump +5
Evan Bayh (D) Former Senator
Rep. Todd Young (R)

15. 15
NEW HAMPSHIRE
Senate Race
RCP: Toss Up; Hassan +2
Cook: Toss Up
FiveThirtyEight: Hassan has a 65.8% chance of winning
Presidential
FiveThirtyEight: Clinton 86.8% Trump 13.1%
RCP Average: Clinton +8
Sen. Kelly Ayotte (R) Incumbent
Gov. Maggie Hassan (D)

16. 16
OHIO
Senate Race
RCP: Likely GOP; Portman +15.8
Cook: Lean R
FiveThirtyEight: Portman has a 96.1% chance of winning
Presidential
FiveThirtyEight: Clinton 61.7% Trump 38.3%
RCP Average: Trump +0.6
Sen. Rob Portman (R)
Incumbent
Ted Strickland (D)
Former Governor

17. 17
PENNSYLVANIA
Senate Race
RCP: Toss Up; Toomey: +1.8
Cook: Toss Up
FiveThirtyEight: McGinty has 54.2% chance of winning
Presidential
FiveThirtyEight: Clinton 87.9% Trump 12.0%
RCP Average: Clinton +6.2
Sen. Pat Toomey
(R) Incumbent
Katie McGinty (D)

18. 18
WISCONSIN
Senate Race
RCP: Leans Dem; Feingold +5.3
Cook: Lean D
FiveThirtyEight: Feingold has a 93.2% chance of winning
Presidential
FiveThirtyEight: Clinton 89.6% Trump 10.4%
RCP Average: Clinton +7
Sen. Ron Johnson (R)
Incumbent
Russ Feingold (D)
Former Senator

19. 19
North Carolina
Senate Race
RCP: Toss Up; Burr +2.8
Cook: Toss Up
FiveThirtyEight: Burr has a 57.9% chance of winning
Presidential
FiveThirtyEight: Clinton 70.1% Trump 29.9%
RCP Average: Clinton +2.5
Sen. Richard Burr (R)
Incumbent
Deborah Ross (D)

20. 20
NEVADA
Senate Race
RCP: Toss Up; Cortez Masto +2.3
Cook: Toss Up
FiveThirtyEight: Cortez Masto has a 56.6% chance of winning
Presidential
FiveThirtyEight: Clinton 72.4% Trump 27.6%
RCP Average: Clinton +4.2
Rep. Joe Heck, DO (R)
Catherine Cortez Masto (D)

21. 21
OTHERS RACES TO WATCH
MISSOURIARIZONA
Senate Race
RCP: Likely GOP; McCain +16
Cook: Lean R
FiveThirtyEight: McCain has 93.1% chance of winning
Senate Race
RCP: Toss Up; Blunt +1.0
Cook: Toss Up
FiveThirtyEight: Kander has a 58.2% chance of winning
Presidential
FiveThirtyEight: Clinton 56% Trump 44%
RCP Average: Clinton 1.3%
Presidential
FiveThirtyEight: Clinton 21.8% Trump
78.2%
RCP Average: Trump +6.7
Sen. John McCain (R) I Rep. Ann Kirkpatrick (D) Sen. Roy Blunt (R) I Jason Kander (D)

22. 22

23. 23

24. NV
CA
AZ
CO
UT
VA
TX
FL
MI
WI
MN
IL
IA
NE
As few as 37 House races could be close in 2016
PA
NY
ME
NH
NJ
MI-01
MI-07
MN-03
WI-08
MN-02
MN-08
IA-01
IA-03
IL-10
NE-02
Midwest
■ Lean Democratic ■ Toss Up ■ Lean Republican
Competitive* 2016 House races, by status of race
Southeast
Northeast
CA-07
CA-24
NV-04
AZ-01
CA-25
CO-06
NV-03
CA-10
CA-21
CA-49
UT-04
West
*Competitive in this presentation
refers to toss up and lean races
Source: The Cook Political Report, 2016.
FL-07
FL-18
FL-26
TX-23
VA-10 FL-13
ME-02
NY-19
NY-22
PA-08
NJ-05
NY-01
NY-23
NY-24
NH-01
NY-03

25. 25
Republicans Have More at Stake in 2016, But
Aren’t Expected to See Big Losses in the House
17 GOP House Seats are Rated as Toss Up Races
For the 2016 Election
2 Democratic House Seats are Rated as Toss Up Races
For the 2016 Elections
CA-10 Denham IL-10 Dold NY-19 OPEN
CA-25 Knight IA-01 Blum NY-22 OPEN
CA-49 Issa ME-02 Poliquin PA-08 OPEN
CO-06 Coffman MN-02 OPEN VA-10 Comstock
FL-07 Mica NV-03 OPEN TX-23 Hurd
FL-26 Curbelo NJ-05 Garrett
FL-18 OPEN
NE-02 Ashford
Democrats need a net gain of 30 seats in the House, there are currently only 37 competitive races, including six that are
now held by Democrats. To capture a majority, Democrats would need to win all six competitive races that are currently
rated as “Lean Democrat” in The Cook Political Report, all 18 races that are rated as “Toss Ups,” and 11 of the 13 races in
the “Lean Republican” category.

26. 26