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The idea that millions of dead Americans are receiving Social Security checks is shocking, and bolsters the argument that the federal bureaucracy needs radical change to combat waste and fraud. There’s one big problem: No evidence exists that it’s true.

Despite being told by agency staff last month that this claim has no basis in fact, Elon Musk and President Donald Trump have continued to use the talking point as a pretext to attack America’s highest-spending government program. Musk seems to have gotten this idea from a list of Social Security recipients who did not have a death date attached to their record. Agency employees reportedly explained to Musk’s DOGE team in February that the list of impossibly ancient individuals they found were not necessarily receiving benefits (the lack of death dates was related to an outdated system).

And yet, in his speech to Congress last week, Trump stated: “Believe it or not, government databases list 4.7 million Social Security members from people aged 100 to 109 years old.” He said the list includes “3.5 million people from ages 140 to 149,” among other 100-plus age ranges, and that “money is being paid to many of them, and we’re searching right now.” In an interview with Fox Business on Monday, Musk discussed the existence of “20 million people who are definitely dead, marked as alive” in the Social Security database. And DOGE has dispatched 10 employees to try to find evidence of the claims that dead Americans are receiving checks, according to documents filed in court on Wednesday.

Musk and Trump have long maintained that they do not plan to attack Social Security, Medicare, and Medicaid, the major entitlement programs. But their repeated claims that rampant fraud exists within these entitlement systems undermine those assurances. In his Fox interview on Monday, Musk said, “Waste and fraud in entitlement spending—which is most of the federal spending, is entitlements—so that’s like the big one to eliminate. That’s the sort of half trillion, maybe $600, $700 billion a year.” Some observers interpreted this confusing sentence to mean that Musk wants to cut the entitlement programs themselves. But the Trump administration quickly downplayed Musk’s comments, insisting that the federal government will continue to protect such programs and suggesting that Musk had been talking about the need to eliminate fraud in the programs, not about axing them. “What kind of a person doesn’t support eliminating waste, fraud, and abuse in government spending?” the White House asked in a press release.

The White House’s question would be a lot easier to answer if Musk, who has called Social Security a “Ponzi scheme,” wasn’t wildly overestimating the amount of fraud in entitlement programs. Musk is claiming waste in these programs on the order of hundreds of billions of dollars a year, but a 2024 Social Security Administration report found that the agency lost closer to $70 billion total in improper payments from 2015 to 2022, which accounts for about 1 percent of Social Security payments. Leland Dudek, a mid-level civil servant elevated to temporarily lead Social Security after being put on administrative leave for sharing information with DOGE, pushed back last week on the idea that the agency is overrun with fraud and that dead people older than 100 are getting payments, ProPublica reported after obtaining a recording of a closed-door meeting. DOGE’s false claim about dead people receiving benefits “got in front of us,” one of Dudek’s deputies reportedly said, but “it’s a victory that you’re not seeing more [misinformation], because they are being educated.” (Dudek did not respond to ProPublica’s request for comment.)

Some 7 million Americans rely on Social Security benefits for more than 90 percent of their income, and 54 million individuals and their dependents receive retirement payments from the agency. Even if Musk doesn’t eliminate the agency, his tinkering could still affect all of those Americans’ lives. On Wednesday, DOGE dialed back its plans to cut off much of Social Security’s phone services (a commonly used alternative to its online programs, particularly for elderly and disabled Americans), though it still plans to restrict recipients’ ability to change bank-deposit information over the phone.

In recent weeks, confusion has rippled through the Social Security workforce and the public; many people drop off forms in person, but office closures could disrupt that. According to ProPublica, several IT contracts have been cut or scaled back, and several employees reported that their tech systems are crashing every day. Thousands of jobs are being cut, including in regional field offices, and the entire Social Security staff has been offered buyouts (today is the deadline for workers to take them). Martin O’Malley, a former commissioner of the agency, has warned that the workforce reductions that DOGE is seeking at Social Security could trigger “system collapse and an interruption of benefits” within the next one to three months.

In going anywhere near Social Security—in saying the agency’s name in the same sentence as the word eliminate—Musk is venturing further than any presidential administration has in recent decades. Entitlement benefits are extremely popular, and cutting the programs has long been a nonstarter. When George W. Bush raised the idea of partially privatizing entitlements in 2005, the proposal died before it could make it to a vote in the House or Senate.

The DOGE plan to cut $1 trillion in spending while leaving entitlements, which make up the bulk of the federal budget, alone always seemed implausible. In the November Wall Street Journal op-ed announcing the DOGE initiative, Musk and Vivek Ramaswamy (who is no longer part of DOGE) wrote that those who say “we can’t meaningfully close the federal deficit without taking aim at entitlement programs” are deflecting “attention from the sheer magnitude of waste, fraud and abuse” that “DOGE aims to address.” But until there’s clear evidence that this “magnitude” of fraud exists within Social Security, such claims enable Musk to poke at what was previously untouchable.

Related:

DOGE’s fuzzy math Is DOGE losing steam?

Here are four new stories from The Atlantic:

Democrats have a man problem. There was a second name on Rubio’s target list. The crimson face of Canadian anger The GOP’s fears about Musk are growing.

Today’s News

Senate Minority Leader Chuck Schumer said that Democrats will support a Republican-led short-term funding bill to help avoid a government shutdown. A federal judge ruled that probationary employees fired by 18 federal agencies must be temporarily rehired. Mark Carney was sworn in as Canada’s prime minister, succeeding Justin Trudeau as the Liberals’ leader.

Dispatches

Atlantic Intelligence: The Trump administration is embracing AI. “Work is being automated, people are losing their jobs, and it’s not at all clear that any of this will make the government more efficient,” Damon Beres writes. The Books Briefing: Half a decade on, we now have at least a small body of literary work that takes on COVID, Maya Chung writes.

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Evening Read

Illustration by John Gall*

I’d Had Jobs Before, but None Like This

By Graydon Carter

I stayed with my aunt the first night and reported to the railroad’s headquarters at 7 o’clock the next morning with a duffel bag of my belongings: a few pairs of shorts, jeans, a jacket, a couple of shirts, a pair of Kodiak work boots, and some Richard Brautigan and Jack Kerouac books, acceptable reading matter for a pseudo-sophisticate of the time. The Symington Yard was one of the largest rail yards in the world. On some days, it held 7,000 boxcars. Half that many moved in and out on a single day. Like many other young men my age, I was slim, unmuscled, and soft. In the hall where they interviewed and inspected the candidates for line work, I blanched as I looked over a large poster that showed the outline of a male body and the prices the railroad paid if you lost a part of it. As I recall, legs brought you $750 apiece. Arms were $500. A foot brought a mere $250. In Canadian dollars.

Read the full article.

More From The Atlantic

The kind of thing dictators do Trump is unleashing a chaos economy. RFK Jr. has already broken his vaccine promise. The NIH’s grant terminations are “utter and complete chaos.” Netanyahu doesn’t want the truth to come out. Republicans tear down a Black Lives Matter mural.

Culture Break

Music Box Films

Watch. The film Eephus (in select theaters) is a “slow movie” in the best possible way, David Sims writes.

Read. Novels about women’s communities tend toward utopian coexistence or ruthless backbiting. The Unworthy does something more interesting, Hillary Kelly writes.

Play our daily crossword.

Stephanie Bai contributed to this newsletter.

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President Donald Trump’s administration is embracing AI. According to reports, agencies are using the technology to identify places to cut costs, figure out which employees can be terminated, and comb through social-media posts to determine whether student-visa holders may support terror groups. And as my colleague Matteo Wong reported this week, employees at the General Services Administration are being urged to use a new chatbot to do their work, while simultaneously hearing from officials that their jobs are far from secure; Thomas Shedd, the director of the GSA division that produced the AI, told workers that the department will soon be “at least 50 percent smaller.”

This is a haphazard leap into a future that tech giants have been pushing us toward for years. Work is being automated, people are losing their jobs, and it’s not at all clear that any of this will make the government more efficient, as Elon Musk and DOGE have promised.

Illustration by The Atlantic. Sources: pressureUA / Getty; Thanasis / Getty.

DOGE’s Plans to Replace Humans With AI Are Already Under Way

By Matteo Wong

A new phase of the president and the Department of Government Efficiency’s attempts to downsize and remake the civil service is under way. The idea is simple: use generative AI to automate work that was previously done by people.

The Trump administration is testing a new chatbot with 1,500 federal employees at the General Services Administration and may release it to the entire agency as soon as this Friday—meaning it could be used by more than 10,000 workers who are responsible for more than $100 billion in contracts and services. This article is based in part on conversations with several current and former GSA employees with knowledge of the technology, all of whom requested anonymity to speak about confidential information; it is also based on internal GSA documents that I reviewed, as well as the software’s code base, which is visible on GitHub.

Read the full article.

What to Read Next

Elon Musk looks desperate: “Musk has wagered the only thing he can’t easily buy back—the very myth he created for himself,” Charlie Warzel writes. Move fast and destroy democracy: “Silicon Valley’s titans have decided that ruling the digital world is not enough,” Kara Swisher writes.

P.S.

The internet can still be good. In a story for The Atlantic’s April issue, my colleague Adrienne LaFrance explores how Reddit became arguably “the best platform on a junky web.” Reading it in between editing stories about AI, I was struck by how much of what Adrienne described was fundamentally human: “There is a subreddit where violinists gently correct one another’s bow holds, a subreddit for rowers where people compare erg scores, and a subreddit for people who are honest-to-God allergic to the cold and trade tips about which antihistamine regimen works best,” she writes. “One subreddit is for people who encounter cookie cutters whose shapes they cannot decipher. The responses reliably entail a mix of sincere sleuthing to find the answer and ridiculously creative and crude joke guesses.” How wholesome!

— Damon

Mycobacterium tuberculosis is a near-perfect predator. In 1882, Robert Koch, the physician who discovered the microbe, told a room full of scientists that it caused one in seven of all deaths. In 2023, after a brief hiatus, tuberculosis regained from COVID its status as the world’s deadliest infectious disease—a title it has held for most of what we know of human history.

Some people die of TB when their lungs collapse or fill with fluid. For others, scarring leaves so little healthy lung tissue that breathing becomes impossible. Or the infection spreads to the brain or the spinal column, or they suffer a sudden, uncontrollable hemorrhage. Lack of appetite and extreme abdominal pain can fuel weight loss so severe that it whittles away muscle and bone. This is why TB was widely known as “consumption” until the 20th century—it seemed to be a disease that consumed the very body, shrinking and shriveling it. On a trip to Sierra Leone in 2019, I met a boy named Henry Reider, whose mix of shyness and enthusiasm for connection reminded me of my own son. I thought he was perhaps 9 years old. His doctors later told me that he was in fact 17, his body stunted by a combination of malnutrition and tuberculosis.

The cure for TB—roughly half a year on antibiotics—has existed since the 1950s, and works for most patients. Yet, in the decades since, more than 100 million people have died of tuberculosis because the drugs are not widely available in many parts of the world. The most proximate cause of contemporary tuberculosis deaths is not M. tuberculosis, but Homo sapiens. Now, as the Trump administration decimates foreign-aid programs, the U.S. is both making survival less likely for people with TB and risking the disease becoming far more treatment-resistant. After decades of improvement, we could return to something more like the world before the cure.

[Read: The danger of ignoring tuberculosis]

Anyone can get tuberculosis—in fact, a quarter of all humans living now, including an estimated 13 million Americans, have been infected with the bacterium, which spreads through coughs, sneezes, and breaths. Most will only ever have a latent form of the infection, in which infection-fighting white blood cells envelop the bacteria so it cannot wreak havoc on the body. But in 5 to 10 percent of infections, the immune system can’t produce enough white blood cells to surround the invader. M. tuberculosis explodes outward, and active disease begins.

Certain triggers make the disease more likely to go from latent to active, including air pollution and an immune system weakened by malnutrition, stress, or diabetes. The disease spreads especially well along the trails that poverty has blazed for it: in crowded living and working conditions such as slums and poorly ventilated factories. Left untreated, most people who develop active TB will die of the disease.

In the early 1980s, physicians and activists in Africa and Asia began sounding the alarm about an explosion of young patients dying within weeks of being infected instead of years. Hours after entering the hospital, they were choking to death on their own blood. In 1985, physicians in Zaire and Zambia noted high rates of active tuberculosis among patients who had the emerging disease now known as HIV/AIDS. TB surged globally, including in the U.S. Deaths skyrocketed. From 1985 to 2005, roughly as many people died of tuberculosis as in World War I, and many of them also had HIV. In 2000, nearly a third of the 2.3 million people who died of tuberculosis were co-infected with HIV.

[Read: Tragedy would unfold if Trump cancels Bush’s AIDS program]

By the mid-1990s, antiretroviral cocktails made HIV a treatable and survivable disease in rich communities. While a person is taking these medications, their viral levels generally become so low as to be undetectable and untransmittable; if a person with HIV becomes sick with tuberculosis, the drugs increase their odds of survival dramatically. But rich countries largely refused to spend money on HIV and TB meds in low- and middle-income countries. They cited many reasons, including that patients couldn’t be trusted to take their medication on time, and that resources would be better spent on prevention and control. In 2001, the head of the U.S. Agency for International Development had this to say when explaining to Congress why many Africans would not benefit from access to HIV medications: “People do not know what watches and clocks are. They do not use Western means for telling time. They use the sun. These drugs have to be administered during a certain sequence of time during the day and when you say take it at 10:00, people will say, ‘What do you mean by 10:00?’” A 2007 review of 58 studies on patient habits found that Africans were more likely to adhere to HIV treatment regimens than North Americans.

In the mid-2000s, programs such as PEPFAR and the Global Fund finally began distributing antiretroviral therapy to millions of people living with HIV in poor countries. PEPFAR, a U.S.-funded initiative, was especially successful, saving more than 25 million lives and preventing 7 million children from being born with HIV. These projects lowered deaths and infections while also strengthening health-care systems, allowing low-income countries to better respond to diseases as varied as malaria and diabetes. Millions of lives have been saved—and tuberculosis deaths among those living with HIV have declined dramatically in the decades since.

Still, tuberculosis is great at exploiting any advantage that humans hand it. During the coronavirus pandemic, disruptions to supply chains and TB-prevention programs led to an uptick in infections worldwide. Last year, the U.S. logged more cases of tuberculosis than it has in any year since the CDC began keeping count in the 1950s. Two people died. But in some ways, at the beginning of this year, the fight against tuberculosis had never looked more promising. High-quality vaccine candidates were in late-stage trials. In December, the World Health Organization made its first endorsement of a TB diagnostic test, and global health workers readied to deploy it.

[Read: America can’t just unpause USAID]

Now that progress is on the verge of being erased. Since Donald Trump has taken office, his administration has dismantled USAID, massively eliminating foreign-aid funding and programs. According to The New York Times, hundreds of thousands of sick patients have seen their access to medication and testing suddenly cut off. A memo released by a USAID official earlier this month estimated that cases of multidrug-resistant tuberculosis will rise by about 30 percent in the next few years, an unprecedented regression in the history of humankind’s fight against the disease. (The official was subsequently placed on administrative leave.) Research on tuberculosis tests and treatments has been terminated. Although the secretary of state and Elon Musk have assured the public that the new administration’s actions have not disrupted the distribution of life-saving medicine, that just isn’t true. A colleague in central Africa sent me a picture of TB drugs that the U.S. has already paid for sitting unused in a warehouse because of stop-work orders. (Neither the State Department nor DOGE employees responded to requests for comment.)

Last year, roughly half of all international donor funding for tuberculosis treatment came from the U.S. Now many programs are disappearing. In a recent survey on the impact of lost funding in 31 countries, one in four organizations providing TB care reported they have shut down entirely. About half have stopped screening for new cases of tuberculosis. The average untreated case of active tuberculosis will spread the infection to 10 to 15 people a year. Without treatment, or even a diagnosis, hundreds of thousands more people will die—and each of those deaths will be needless.

By revoking money from global-health efforts, the U.S. has created the conditions for the health of people around the world to deteriorate, which will give tuberculosis even more opportunities to kill. HIV clinics in many countries have started rationing pills as drug supplies run dangerously low, raising the specter of co-infection. Like HIV, insufficient nutrition weakens the immune system. It is the leading risk factor for tuberculosis. An estimated 1 million children with severe acute malnutrition will lose access to treatment because of the USAID cuts, and refugee camps across the world are slashing already meager food rations.

For billions of people, TB is already a nightmare disease, both because the bacterium is unusually powerful and because world leaders have done a poor job of distributing cures. And yet, to the extent that one hears about TB at all in the rich world, it’s usually in the context of a looming crisis: Given enough time, a strain of tuberculosis may evolve that is resistant to all available antibiotics, a superbug that is perhaps even more aggressive and deadly than previous iterations of the disease.

[Read: Resistance to the antibiotic of last resort is silently spreading]

The Trump administration’s current policies are making such a future more plausible. Even pausing TB treatment for a couple of weeks can give the bacterium a chance to evolve resistance. The world is ill-prepared to respond to drug-resistant TB, because we have shockingly few treatments for the world’s deadliest infectious disease. Between 1963 and 2012, scientists approved no new drugs to treat tuberculosis. Doing so stopped being profitable once the disease ceased to be a crisis in rich countries. Many strains of tuberculosis are already resistant to the 60-year-old drugs that are still the first line of treatment for nearly all TB patients. If a person is unlucky enough to have drug-resistant TB, the next step is costly testing to determine if their body can withstand harsh, alternative treatments. The United States helped pay for those tests in many countries, which means that now fewer people with drug-resistant TB are being diagnosed or treated. Instead, they are almost certainly getting sicker and spreading the infection.

Drug-resistant TB is harder to cure in individual patients, and so the aid freeze will directly lead to many deaths. But giving the bacteria so many new opportunities to develop drug resistance is also a threat to all of humanity. We now risk the emergence of TB strains that can’t be cured with our existing tools. The millennia-long history of humans’ fight against TB has seen many vicious cycles. I fear we are watching the dawn of another.

This article has been adapted from John Green’s forthcoming book, Everything Is Tuberculosis.