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Affiliates from Elon Musk’s so-called Department of Government Efficiency (DOGE) have significant access to 19 sensitive systems at the Department of Health and Human Services (HHS), according to a recent court filing. Nine of those are previously undisclosed.

This wide-ranging access, which includes a centralized accounting system for all Centers for Medicare and Medicaid (CMS) programs, the cloud for a “robust” and “high-volume data warehouse,” and several additional HHS accounting systems that pay government contractors, demonstrates the breadth of DOGE’s takeover at the federal agency charged with securing health care for millions of Americans.

HHS submitted the filing as part of an ongoing lawsuit. The document—which is related to a motion for preliminary injunction—shows that a total of four DOGE affiliates now have access to the Healthcare Integrated General Ledger Accounting System (HIGLAS), which pays out federal grants and is used for accounting by the Centers for Medicare and Medicaid Services. A previous court filing claimed three DOGE operatives had access to HIGLAS, which could theoretically allow them to cut off Medicaid payments to states, according to NPR.

HHS did not immediately respond to an official request for comment from WIRED.

DOGE’s access to some of the databases in the new court filing were first revealed in a March court filing and reporting from NPR and The Guardian. However, the full scope has come into focus as a result of the American Federation of Labor and Congress of Industrial Organizations’s continued lawsuit attempting to restrict DOGE’s data access at HHS, the Department of Labor, and the Consumer Financial Protection Bureau. As part of the AFL-CIO’s motion, the plaintiffs allege the agencies have given DOGE “unfettered, on-demand access to their most sensitive systems of records” because the affiliates “invoke the incantation of ‘waste, fraud, and abuse.’” According to the plaintiffs, “‘waste, fraud, and abuse’ are not magic words, and they cannot conjure up a need to grant DOGE Team members on-demand access to Americans’ most sensitive and personal information.”

As part of the discovery process, federal agencies have been required to disclose which databases DOGE has accessed, which were attached to the plaintiffs’ recent motion.

Jeffrey Levi, an emeritus professor of health policy and management at George Washington University’s Milken Institute School of Public Health, tells WIRED that “anything that has the potential of delaying payments to parts of the health system” runs the risk of disrupting care for the millions of Americans that rely on it. Levi notes that places with “minimal financial flexibility”—like rural hospitals and Federally Qualified Health Centers, which disproportionately serve people who use Medicaid and Medicare—are particularly vulnerable.

The filing lists known DOGE affiliates, including Luke Farritor, Marko Elez, Edward Coristine, Rachel Riley, Aram Moghaddassi, Zachary Terrell, and Kyle Schutt, among those who have access to HHS systems. Coristine, who has gone by the name “Big Balls” online, previously worked for a company that employed convicted and reformed hackers, WIRED reported.

Elez, a young engineer who has worked at Musk’s X and SpaceX, has also appeared at the Department of Labor, the Social Security Administration, and the Department of the Treasury. While at the Treasury, WIRED reported, Elez had both read and write access to sensitive payments systems. In early February, Elez briefly resigned from DOGE after racist comments posted by an account he was linked to were discovered by The Wall Street Journal, though Elez returned to DOGE after Musk and Vice President JD Vance posted in defense of him on X.

The court filing raises legal and ethical questions around how personal information is currently being treated in the federal government, says Elizabeth Laird, the Center for Democracy and Technology’s director of Equity in Civic Technology.

“It just underscores why for so long we have had protections that have really centered someone’s right to privacy and [required] consent for sharing that level of sensitivity of information about them,” Laird says. “Just in this agency, with this level of sensitivity, that’s a right that’s been stripped away from every person who is included in there.”

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