1 - You need to enable migrations, prefereably with EntityFramework 5.
They made it easy to modify the profile with SimpleMembership. SimpleMembership is using the code first EF model and the user profile is defined in the file AccountModels.cs that is generated as part of the Internet template for MVC 4. Just modify the class UserProfile and add the new fields in the class definition.
For example, adding a field for email would look something like this.
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