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Interview: Heather Boushey, economist and member of the Council of Economic Advisers
In which we talk all about Bidenomics.
In the early 2010s, when I started going to Heather Boushey’s parties at the American Economic Association meetings. The attendees were a startlingly prestigious array of progressive thinkers from all corners of the profession, and even from outside it. Most AEA events are rather sleepy affairs where people catch up with colleagues and make small talk; at Boushey’s events, people discussed big ideas. I remember thinking: These people are going to change the country.
And in fact, that is precisely what happened. With relatively little input from most of the prestigious academics who go to the AEA conferences, the Biden administration is tearing up America’s economic playbook and writing a new one. Although Biden’s attempt to reimagine the welfare state was interrupted by inflation and a few centrist senators, the administration is charging ahead with industrial policy. And the economists who went to Heather Boushey’s AEA parties, and their ideas, have played a key role in that revolution.
Not least among those influential figures is Boushey herself, who now sits on the Council of Economic Advisors. If you want to understand the economic philosophy underlying Biden’s policies, and the trajectory of progressive policy and thought over the next decade or two, there are few better people you could talk to. And so I did. Most of my interviews are done one email at a time, but due to Heather’s busy schedule, this one was sent in two batches of questions (in case you’re wondering why I don’t spend much time following up on her answers). Anyway, there are definitely a lot of administration talking points in here — that’s pretty much de rigueur for a sitting member of the CEA — but there’s also a wealth of info about how Biden and his advisors think about the economy and about their role in reshaping it.
N.S.: When Biden came to power, what were your top policy goals for the administration, and why?
H.B.: When the President took office, he had to address the crises in front of him. It was of vital importance that the Administration respond quickly and boldly to the COVID-19 pandemic and economic situation. It’s important to remember that when President Biden was inaugurated in January 2021, this was by many accounts the worst time in the pandemic. Roughly one percent of Americans were fully vaccinated and thousands were dying every day. At the same time, the economy was struggling, with businesses and schools still shuttered, and the unemployment rate was 6.3 percent. Getting the pandemic under control and the economy back on track were job one.
Yet, the President was always clear that we couldn’t simply go back to the way things were; in his words, we needed to build back better. There was a set of long-term challenges—some of which became more visible and urgent during the pandemic—including the need for more resilient supply chains, for investments in infrastructure across the nation, to confront the existential crisis of climate change through building a clean energy economy, and to address long-standing racial inequities. Each of these challenges was harming our economy; take climate change, for example, which has been reducing GDP growth and has been deleterious to the health and wellbeing of so many Americans, particularly in lower-income communities and communities of color.
There was also the fact that markets were no longer delivering on the promise of shared growth. Over nearly a half century, across income and wealth, families at the top half pulled farther and farther ahead, leaving middle- and lower-income families facing a cost-of-living crisis that was preventing families from affording necessities like food, energy, and care. And, markets have become increasingly concentrated, leading to higher prices and unfair outcomes for small- and medium-sized businesses. According to one estimate, since the late 1990s, over 75 percent of U.S. industries had experienced an increase in concentration level.
These multifaceted challenges have affected the wellbeing of Americans as well as the overall growth and resilience of the economy and the President articulated plans to address each.
N.S.: There are rumors that economists have become much less influential in the Biden administration compared to previous presidential administrations. Would you say that’s true? How has the relationship between politicians and the economics profession changed?
H.B.: Perhaps I’m biased, but I think that’s absolutely not true. Of course, good policymaking is an interdisciplinary exercise; it requires listening to the voices of economists and all kinds of other experts – including historians, sociologists, political scientists, lawyers, climate scientists, activists, working families, and others. Since Day 1, the President has put in place a set of historic legislation and executive orders that are grounded in economic research and expertise about how best to promote shared, stable, and sustainable economic growth. For example, the Executive Order On Advancing Racial Equity and Support for Underserved Communities Through the Federal Government called on agencies to identify the best methods, consistent with applicable law, to assist agencies in assessing equity with respect to race, ethnicity, religion, income, geography, gender identity, sexual orientation, and disability, while the Executive Order on Climate-Related Financial Risk called for new data and methods to assess the economic risks of climate change and the global shift away from carbon-intensive energy sources and industrial processes. And, in many other areas—such as the elimination of junk fees—the Administration has shed light on innovative economic research, showing that regulation in this area can increase competition and lower costs for consumers.
I do think, however, that this Administration has emerged at a time of change in the field of economics, and we can see the influence of those changes in our economic policy. For example, the massive risks that climate change poses for health, productivity, infrastructure, financial markets, inequality, and growth have prompted a shift for many economists towards seeking to understand the role government investment could play in innovation and specific key industries to spur the transformative changes needed to reduce emissions and limit the damages of climate change. You can clearly see these ways of thinking in the design of the Inflation Reduction Act, which includes historic investments in reducing U.S. emissions and creating domestic hubs for the clean-energy industries of the future.
Likewise, the resources that are most important to our economy have drastically changed. Semiconductors have become the building blocks of our economy and are a part of everything from cars to refrigerators to cellphones. Yet, the U.S. share of modern semiconductor manufacturing capacity has dropped 25 percentage points (68 percent) since 1990. During the pandemic, we saw how shortages threatened the U.S. economy—by one estimate, the global semiconductor shortage impacted 169 separate industries. And we can see economists engaging in the new questions around how resilient our supply chains are. The significance of these inputs, and concerns about our supply chains, are driving factors behind the President’s CHIPS and Science Act, which provides $52.7 billion in funding for semiconductor manufacturing, research, and development.
N.S.: What would you rate as the administration’s greatest successes so far? Where has it come up short?
H.B.: The evidence is clear that this Administration has had some tremendous successes. In that, I include the economic recovery from the COVID-19 pandemic—the United States leads the G7 in pandemic economic recovery and we saw the strongest growth in about 40 years in 2021. The United States has experienced the fastest and most equitable economic recovery in decades; in 2021 and 2022, we experienced the two strongest years of job growth on record and we began 2023 with the lowest unemployment rate since 1969. This success was not an accident and the many lessons learned will inform economic policy in future recessions.
The President has also been successful in signing into law a historic set of legislation, much of it bipartisan. The American Rescue Plan enabled millions of Americans to access COVID vaccines and helped spur the fastest economic recovery in decades. The Bipartisan Infrastructure Law is a once-in-a-generation investment in U.S. infrastructure. The CHIPS and Science Act will strengthen our supply chains and support U.S. domestic manufacturing capabilities in a vital industry of the future. And the Inflation Reduction Act is the largest investment in fighting climate change in history and makes important investments in lowering health care costs for families.
That said, this Administration has much to do. First, we need to implement these historic laws, and I’m excited to support that as the Chief Economist for the Invest in America subcabinet. And, I do want to mention one specific area where we know government intervention is desperately needed: the care industry. Due to challenges in the care industry, the market is unable to supply adequate quality care at a price that families can afford, constraining our labor force and, without additional action, reducing our GDP by hundreds of billions of dollars. That’s why the President’s FY24 Budget prioritizes expanding access to affordable, high-quality early child care and learning by enabling states to increase child care options for more than 16 million young children and lowering costs so that parents can afford to send their children to high- quality child care. The President has urged Congress to pass his plan, but in the meantime, he is also taking action where he can. The recent Notice of Funding Opportunity for the CHIPS and Science Act, for example, requires that applicants for any major semiconductor project have a plan to provide access to high-quality childcare for facility and construction workers—just one way to begin addressing care challenges. And in April, the President signed into law the Executive Order on Increasing Access to High-Quality Care and Supporting Caregivers, the most comprehensive set of executive actions any president has ever taken to improve care for hard-working families while supporting care workers and family caregivers.
N.S.: Why didn’t the American populace seem to embrace the expanded Child Tax Credit?
H.B.: First of all, we would dispute the claim that there was not public support for the expanded Child Tax Credit. A 2022 poll found that nearly 6 in 10 Americans supported the expanded CTC, with 3 in 4 families with children supporting the measure. While Congress did not take action, we believe that the American populace would embrace the expanded CTC along with comprehensive care infrastructure.
Furthermore, we know that the expanded Child Tax Credit was transformative. After the introduction of advance payments, we saw household food insecurity fall by more than a quarter. In 2021 the child poverty rate was cut almost in half to its lowest level on record. And the expanded Child Tax Credit alone lifted 2.1 million children out of poverty.
Although the expanded Child Tax Credit expired at the end of 2021, the case for comprehensive care infrastructure, including the Child Tax Credit, has resonated with the American people. There is a general consensus that families and the economy require a variety of modes of care across different situations, from services that supply quality care, to paid family leave for workers themselves to provide short-term care, to tax credits for families with children to help cover costs. The debate over care infrastructure has moved from whether to how, with those on all sides in general agreement that care infrastructure is important for human development, family well-being, and family economic security for families up and down the income ladder. There has also long been bipartisan support for versions of the Child Tax Credit specifically.
The President believes that the expanded Child Tax Credit is a critical part of comprehensive care infrastructure. That is why he has consistently advocated to restore the expanded Child Tax Credit, including in his FY24 Budget. Restoring the expanded Child Tax Credit would serve as an investment in American families and children now, and for generations to come.
N.S.: How does the change from the disinflationary regime of the post-Great Recession years to the inflationary regime of the post-pandemic years change the calculus for federal policy?
H.B.: I’ll preface this by noting that we have seen inflation come down in recent months; as of July 2023, annual headline Consumer Price Index inflation has fallen for eleven straight months; the United States now has the lowest 12-month harmonized inflation in the G7, both for overall and core inflation. However, as the President has made clear, inflation is still unacceptably high, and bringing prices down is an important priority.
And, let’s remember that today’s inflation has its origins in the global pandemic and ensuing supply-side challenges. During the pandemic, for example, ocean shipping costs temporarily skyrocketed, an increase that likely contributed to overall increases in consumer prices. Or take the semiconductor shortage, which showed up in limited new car supply—and higher car prices—as manufacturers couldn’t get the parts they needed. Spikes in vehicle prices accounted for one-third of the monthly increase in the Consumer Price Index in 2021. And, then, the situation was exacerbated by the unprovoked war Putin is waging in Ukraine, which pushed up energy and food prices around the world.
One consequence of high inflation for federal policy is that it has made the cost-of-living crisis even more pressing. Although inflation is the purview of the Federal Reserve, the Administration has been very focused on taking action to lower costs for American families and respond to these ongoing challenges. There are many examples here, but I’ll highlight a few. On healthcare through the Inflation Reduction Act, the President signed into law enhanced premium tax credits, which are estimated to save 13 million Americans hundreds of dollars per year on insurance premiums; capped drug expenses for seniors and people with disabilities on Medicare at $2,000 per year while letting Medicare negotiate drug prices and imposing a tax penalty if drug companies increase their prices faster than inflation; and limited the price of a month’s supply of insulin to $35 for Medicare beneficiaries. Through the Bipartisan Infrastructure Law’s Affordable Connectivity Program, the Administration has lowered internet costs for roughly 16 million households. Finally, the Administration modernized the Thrifty Food Plan to increase its purchasing power for the first time since it was introduced in 1975, raising SNAP benefits by $36.24 per person per month.
Inflation also makes the Administration’s work to invest in the long-term capacity of the economy all the more important. As laid out in the Biden-Harris Economic Blueprint and a past CEA blog, the Bipartisan Infrastructure Law, CHIPS and Science Act, and Inflation Reduction Act form the core of the President’s Modern American Industrial Strategy, and are investments that will expand the overall capacity of the economy, create good jobs, and lower prices, which will together foster strong, sustainable, and shared economic growth in the long-run. As Treasury Secretary Janet Yellen has described it, it’s a modern supply side agenda.
Finally, this moment has also crystalized how important it is to focus on lowering prices more generally, particularly through addressing rising concentration across firms. Through the Executive Order on Promoting Competition in the American Economy and the creation of the White House Competition Council, the Administration has discouraged anticompetitive behavior in a variety of industries, lowering prices on items from airline tickets to broadband to meat and increasing worker power. Furthermore, proposed actions in the FY24 budget would give families breathing room through affordable health care, child care, home care, higher education, and housing. We are hopeful that many of these policies will be passed over the next two years, but this inflationary moment has helped us develop a progressive toolkit for dealing with prices that will last far beyond this Administration.
N.S.: Everyone’s talking about the extraordinary increase in factory construction spending in the U.S., which has more than doubled in inflation-adjusted terms since summer 2022. That’s exactly when Biden’s two big industrial policy bills were passed, and most of the big new factories that have been announced have been in green energy and semiconductors -- exactly the things that the bills incentivized. Industrial policy works -- at least, in terms of getting companies to spend on factories! So, two questions. First, how sustained do you expect this factory expansion to be? And second, what measures are being taken to make sure that the spending increases translate into real new plant and equipment instead of being swallowed up by cost overruns?
H.B.: Yes, just like you, we’ve been tracking these measures, and we are happy to see the private sector responding to the Administration’s incentives. Since January 2021, inflation-adjusted manufacturing construction spending has increased 84 percent. Other data sources also suggest growing investment. For example, the Administration is tracking private sector announcements of investment in manufacturing and clean energy—since the President took office, companies have announced $503 billion in new investments in industries like semiconductor manufacturing, clean energy, and electric vehicles. The President’s Investing in America agenda is designed to enact change that is government-enabled and private-sector led because we know that spurring private investment is a central part of making sure that these investments solve the problems we face. For example, the International Energy Agency estimates that $4 trillion of annual global investment by 2030 is needed to meet the goals in the Paris Agreement, and that 70 percent of clean energy investments will need to come from the private sector, including developers and financing institutions like banks.
To answer your first question, the President’s investments are largely designed to spend out over a decade, so we expect to see the economic benefits—like increased construction spending and hiring—throughout that time. The clean energy investment and production tax credits last a decade, as do the consumer-facing credits for electric vehicles and homeowner’s investments in clean energy. The funding for the Department of Energy’s Loans Program Office will last between four and six years.
Now, in terms of economic outcomes, factory construction spending is a leading indicator for other kinds of spending, such as hiring workers and purchasing manufacturing inputs—you have to build the factory before you hire manufacturing workers—so there may be relatively more construction spending earlier in the decade, and relatively more spending in other areas, like workers and manufacturing inputs, later in the decade. More broadly, the Investing in America agenda is an investment in the country’s productivity. We know from economic research that investments in infrastructure and research and development can increase productivity and economic growth. That means that even after the spending from our agenda is over, we expect to see long-lasting economic benefits, including increased private sector investment.
To respond to your second question, as you noted, this is inflation-adjusted spending where we are seeing these increases. We are, of course, tracking relevant inflation measures carefully, and we have seen positive developments on that front. For example, looking at Producer Price Index data, over the last year the price index for materials and components for construction fell 0.2 percent and the price index for materials and components for manufacturing fell 5.9 percent. And as the CEA recently noted in a blog, the data indicate that supply chain pressures are now below pre-pandemic averages. We’ll keep tracking these data, and will take action as needed if there are supply chain challenges that limit the implementation of this legislation, but for the time being, we feel confident that this spending is translating into real new plants and equipment.
N.S.: Taken together, do the Inflation Reduction Act and the CHIPS Act represent a shift toward industrial policy, and away from free trade and laissez-faire, as the U.S.’ new guiding economic policy principle?
H.B.: I spoke about this at length in a speech at a recent event at the Peterson Institute for International Economics. As I said then, our economic agenda revisits three basic assumptions that have been embedded in many of America’s economic policies over the last half century.
First, in recent decades, our economic policies assumed that unrestricted markets would use resources productively and efficiently, maximizing our nation’s long-run growth. Second, they assumed that the composition of growth does not matter, that growth accruing to the top would trickle down, and that growth in any industry was equally good. And third, they assumed that the role of government was best suited to fixing consumption gaps with after-the-fact redistribution, rather than delivering growth with equity. In recent decades, we have seen these assumptions fail us repeatedly—in the global financial crisis, in the COVID-19 pandemic, in the offshoring of supply chains for critical goods, in rising inequality, and in our failure to address climate change.
Now of course, we have seen the power of markets and the importance of global trade, including through lower costs for consumers and more access to goods produced throughout the world. The President’s economic agenda preserves those benefits. The United States always has been, and always will be, an active and engaged participant in the global trading system. But the President’s agenda also understands that the global trading system has not always been fair, or delivered shared benefits, and that markets alone cannot always provide for shared, stable, sustainable economic growth.
So the Administration is building a modern American industrial strategy, investing in building the capacity and potential of the American economy through targeted public investments in essential infrastructure and industries critical for our economic and national security—where private investment has proved insufficient. As I noted previously, in recent speeches, Secretary Janet Yellen has described this as a “modern supply side economics,” saying that “our policies are designed to expand the productive capacity of the American economy. That is, to raise the ceiling for what our economy can produce.” Our strategy doesn’t mean replacing the private sector; it means working with it as a partner, and allowing the market to continue to do what it does best—lowering costs, discovering new technologies, and uplifting successful businessmodels.
As National Security Advisor Jake Sullivan said in a speech in April, “we will unapologetically pursue our industrial strategy at home—but we are unambiguously committed to not leaving our friends behind. We want them to join us. In fact, we need them to join us.” For critical industries like semiconductors and clean energy, we are far from the global saturation point of the public and private investments needed. That is why we are working with our partners to better share information and coordinate our incentive programs. We are working to do all of these things bilaterally, through the G7, and with new economic arrangements we are pursuing in key regions.
N.S.: How is the economic competition with China motivating the Biden administration’s economic policy?
H.B.: The Administration’s economic policy is influenced by the global economic context, including economic competition with China.
As Jake Sullivan said in his speech, by the time President Biden entered office, a large non-market economy had been integrated into the international economic order in a way that posed considerable challenges. China’s state-led, non-market approach to the economy and trade continues to shape the industrial policies that China pursues, which provide unfair competitive advantages to Chinese companies—both in traditional sectors and emerging sectors, such as clean energy industries. Building the clean energy economy is a global challenge, and we want other countries to invest in the clean energy economy too. At the same time, we needed to invest in supply chain resiliency, which means thinking about how market power is being shaped right now. For example, in large part due to government subsidies, China currently controls over 80 percent of part of the world’s supply chain for batteries used to power EVs. For context, OPEC controls 40 percent of the global crude oil supply. We cannot risk an unexpected crisis or geopolitical tension blocking our access to these critical goods. That is why the Biden administration is investing in critical areas—like clean energy technologies—where the market alone cannot deliver goods essential for our economic and national security.
When it comes to economic competition with China, our administration is influenced by recent history. During the early 1990s and 2000s, rising import competition from China led to lasting job and income losses in U.S. manufacturing communities. By 2011, this so-called “China shock” had led to the loss of one million U.S. manufacturing jobs—and 2.4 million jobs overall. And there’s evidence that these economic outcomes contributed to growing ideological polarization—and racial and ethnic political divides—in the 2000s and 2010s. An important part of our agenda is making sure that global trade benefits Americans and that American workers can access high-quality jobs in their community.
Now I want to emphasize that, when it comes to China, our goal is to de-risk, not decouple our economy from China. We are not cutting off trade. In fact, the United States continues to have a very substantial trade and investment relationship with China. Bilateral trade between the United States and China set a new record last year. And as you’ve heard from Administration officials in recent weeks, we think it is responsible to talk with China on a range of issues including the economy and the climate. But with the actions we’ve taken, we are strengthening America’s ability to outcompete China by rebuilding the economy from the middle out and bottom up, by enhancing our ability to innovate, and by rejuvenating our industrial capacity.
N.S.: There has been a lot of worry that the Inflation Reduction Act won’t be able to build enough solar plants and transmission lines to meet our climate goals, no matter how much money we allocate, due to the procedural requirements of laws like the National Environmental Policy Act (NEPA), which allow local interests to use lawsuits to force cumbersome years-long environmental reviews that sometimes force projects to be abandoned entirely. What is your response to those worries?
H.B.: I think this is an important concern. Local, state, interstate, and federal requirements can individually and collectively pose challenges and threaten the viability of new projects like wind farms and transmission lines—with meaningful implications for the ability of the United States to reach our climate goals. According to one estimate, constraints on transmission expansion could limit the effect of the Inflation Reduction Act on emissions reductions by over 80 percent.
In response to this, we are taking steps to build quickly and efficiently. For example, the Administration has initiated new federal coordination strategies, such as “Dig Once,” where the Departments of Commerce, Energy, and Transportation work to ensure only one excavation is needed for transportation, electrification, and broadband projects at a particular site. The Council on Environmental Quality has issued updated guidance on environmental reviews to help limit time-intensive litigation; the Department of Energy has begun the process of designating National Interest Electric Transmission Corridors to accelerate the deployment of transmission infrastructure; and seven agencies signed a memorandum of understanding to limit delays and hasten the rate at which transmission infrastructure is permitted. Through the Inflation Reduction Act, the Administration has invested $1 billion in key federal permitting agencies to increase staff capacity and incorporate new technologies.
We do not, however, believe building quickly has to come at the expense of equity or inclusivity. For example, the Council on Environmental Quality has also restored community safeguards for the environmental review to help ensure that the federal government works in partnership with communities to minimize environmental and public health costs associated with building new Projects.
We are proud of these accomplishments, and we have seen some recent successes with permitting, like the approval of the SunZia and TransWest transmission projects. Moving forward, we plan to continue our whole-of-government approach to ensuring we can build efficiently, but we also need more tools to address these challenges. That is why the Administration has publicly called for bipartisan legislative action to reform our permitting systems. We know that building quickly and efficiently is vital for addressing the challenges we face, and we need Congress’ help to accomplish that.
N.S.: Obviously, rebuilding our semiconductor industry will require retraining a lot of American workers, but that takes years. Given that time is of the essence, and that experienced semiconductor workers are also needed to train the Americans, don’t we need to be letting in a lot of immigrants from countries like Taiwan, South Korea, and Malaysia, who know how to run chip fabs?
H.B.: The President is committed to implementing his Investing in America agenda in line with what the economic evidence says about how to build lasting industries quickly and cost- effectively—with benefits that are shared by the American people. To build a lasting, durable domestic semiconductor industry in the United States, we know that we need to prioritize creating an economic ecosystem—with stable and resilient supply chains and a highly skilled, diverse workforce. That means that two important first steps to implementing the legislation are creating high-quality jobs for American workers and building long-term educational pipelines for workers in communities across America.
The Commerce Department is acting on this priority by requiring companies seeking CHIPS funding to create high-quality jobs, submit workforce development plans for workers (which include outlining how they will provide those workers with necessary training), and in some cases, provide workers with childcare. The Commerce Department is also strongly encouraging applicants to develop sectoral partnerships—with K-12 institutions, community colleges, training organizations, labor unions, industry associations, and others—to meet their workforce needs. And the Administration is committed to welcoming new talent that can advance our efforts and
technological competitiveness for decades to come. We believe these efforts will help companies quickly hire and train a diverse, skilled workforce to build semiconductors.
N.S.: What would be the administration’s top economic policy priorities for a second term in office?
H.B.: Fundamentally, the Administration is focused on addressing the challenges the country faces—including inequality, the cost-of-living crisis, and climate change—while improving the quality of life for the American people and promoting stable, shared, and sustainable economic growth in the long-term. That was the Administration’s priority in this term and that would be its priority in the second term as well.
As the President laid out recently in his speech on Bidenomics, there are three pillars to his economic agenda. First is the implementation of the Investing in America agenda. This package of legislation is designed to spend out over a decade, and there will be ongoing work and decisions to make sure that implementation is consistent with the economic evidence. That includes evidence on how to create high-quality jobs for American workers, how to reduce our greenhouse gas emissions while supporting strong economic growth, how to shape markets so they are fair and competitive, and how to ensure our supply chains are resilient to shocks. And there will be work to make sure that we overcome barriers to implementation—things like permitting challenges—to make the most of this historic investment.
Bidenomics includes two other pillars. One of those is to empower workers by supporting the creation of good-paying jobs, making sure workers can access the education and training they need to succeed, and ensuring workers have the opportunity to join a union. And, the other is to promote competition to lower costs and ensure opportunity for small businesses and ensure that workers get a fair chance to succeed. Through these three pillars, the President is focused on building an economy from the middle out, fostering growth that is strong, sustainable, and shared.
There are also, of course, important challenges that remain unsolved that the Administration would prioritize addressing. I include in this the challenges in the care industry, which I mentioned earlier. As I noted, we have begun addressing challenges in the care industry—through the CHIPS Notice of Funding Opportunity and a historic Executive Order—but our work is far from over. The President has shown his commitment to it through his proposed FY24 budget. And we need to ensure that our strong economy delivers benefits to all Americans. For example, for decades now, the Black unemployment rate has been roughly double the white unemployment rate. Even in recent months, as the Black unemployment rate has hit record lows, it remains well above the white unemployment rate. The Administration will remain committed to breaking down these inequities through economically sound policies. Likewise, the Administration understands that the cost-of-living crisis is top of mind for so many households, and will continue its work to bring down costs—of things like prescription drugs and internet access—for all Americans.