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Column: Big drug makers are whining about having to negotiate with Medicare, but they can’t afford not to

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Column: Big drug makers are whining about having to negotiate with Medicare, but they can’t afford not to

Given the pharmaceutical industry’s conviction that the government’s Medicare drug negotiation program will “deal a fatal blow” to its innovative research, “coerce” it into sacrificing its rightful profits, kill innocent patients and was also unconstitutional, naturally the companies would decline to participate.

Just kidding.

A few days ago, the White House announced that the manufacturers of all 10 of the first drugs selected for the negotiation process have agreed to participate.

Eight of the manufacturers have challenged the negotiation program in federal lawsuits, in which the above assertions can be found.

AbbVie, the parent of a ninth company with a drug on the negotiation list, is specifically named by the U.S. Chamber of Commerce in its lawsuit as a member with a direct interest in the outcome. So far, cases have been filed by Merck, Johnson & Johnson, AstraZeneca, Novo Nordisk, Bristol Myers Squibb, Novartis, and Boehringer Ingelheim (a partner of Eli Lilly in marketing one of the 10 drugs). The industry’s lobbying arm, Phrma, filed a separate lawsuit.

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That the drug makers are joining the negotiation process even as they engage in judicial whining and mewling about it may be taken as a testament to the cleverness of the program’s design.

Knowing that Medicare can’t walk away from the negotiating table, the key leverage tool in any negotiation — it’s legally bound to cover all drugs approved by the Food and Drug Administration — they made it exceptionally difficult for the drug makers to walk away: They can only do so by withdrawing all their drugs from Medicare, which is the largest drug buyer in the country. They also face an immense excise tax if they fail to negotiate in good faith.

The drug companies say these rules are coercive, trample on their rights to free speech, and are unconstitutional and bad in other ways. But they know their only real option is to hedge their interest by participating in the program and also suing to overturn it, on the chance that at least one judge will see it their way and that the issue will land in our generally business-friendly Supreme Court. Or to put it the other way, to sue to overturn it but also to participate, in case they lose in court.

Before going any further into this conflict, a few words about how the negotiation process works.

Medicare’s right to negotiate drug prices with their manufacturers was enacted as part of the Inflation Reduction Act, which President Biden signed in August 2022. The act aims to reduce prescription drug prices in several ways.

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It requires drug companies to pay a rebate to Medicare if they raise prices faster than inflation on drugs used by Medicare members. Starting next year, it eliminates the “donut hole” in the Medicare drug benefit, which imposes co-pays on enrollees after their spending reaches a certain level; it also caps their out-of-pocket spending at $2,000 a year starting in 2025. It caps cost-sharing on insulin for Medicare patients at $35 a month.

These provisions are likely to cut spending on prescription drugs for millions of seniors on Medicare.

As for the negotiation program, Medicare was required this year to select 10 branded, non-generic drugs from those on which it spends the most; 30 more drugs will be added to the list in 2025 and 2026, and more in subsequent years.

The companies had until Oct. 1 to signal their participation, with negotiations continuing through next July, with prices to take effect in 2026. The negotiated price will have to be at least a 25% to 60% discount from a drug’s average price on the non-federal market.

Big drug companies spent more on shareholder dividends and stock buybacks in 2016-2020 than on research and development.

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(House Committee ion Oversight and Reform)

The 10 drugs selected in the first round included the blockbuster blood clot drugs Xarelto and Eliquis, which are taken by a total of more than 5 million Medicare enrollees, and diabetes, autoimmune, cancer and cardiac drugs taken by about 4.7 million enrollees. The manufacturers are largely the same names as those appearing as plaintiffs in federal court — very much a Big Pharma aristocracy.

Some of the lawsuits give the impression of throwing everything at the wall in the hopes that something will stick, no matter how implausible. My favorite in this vein is a passage in AstraZeneca’s lawsuit shedding crocodile tears over the impact of the negotiation program on the development of “orphan” drugs. These are drugs aimed at conditions affecting fewer than 200,000 U.S. patients.

Because the markets for these drugs are so small, the company says, drug companies “take on enormous risks in developing new drug products and new indications for existing products” for them. The negotiation program’s regulations “undermine the incentives for manufacturers to take on that risk.”

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Izzatso? In the first place, the negotiation program covers a few score drugs costing Medicare the most; almost by definition, orphan drugs probably will never fall into that category.

In the second place, AstraZeneca doesn’t happen to mention the special treatment that orphan drugs receive from the federal government. They get fast-tracked through the Food and Drugs Administration review process, enhanced tax credits for clinical trials, and lengthier exclusivity rights than other drugs. None of those benefits is affected by the Medicare negotiation process.

Then there’s the lawsuit filed Sept. 29 by Novo Nordisk, maker of a family of diabetes drugs on the Medicare negotiation roster. According to its lawsuit, “In recent decades, the federal government has taken control over large segments of the nation’s healthcare markets.”

The sheer nerviness of this assertion is astounding. All we can say is: Would that it were so, then healthcare in America would be changed infinitely for the better. If Novo Nordisk really wants to know what it’s like in a land where the government takes control of healthcare, it need only look to its home country, Denmark, which provides universal healthcare to citizens and residents for free.

That brings us to the other claims the industry makes in its lawsuits and its PR. In an earlier column, I disposed of the idea that the companies are being coerced into participating in the negotiations. The truth is that manufacturers have every right to refuse. The penalty of a punitive tax only applies to drug companies that sell any drugs to Medicare or Medicaid.

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That’s their choice: No one forces Merck to participate in Medicare and Medicaid, as Nicholas Bagley of the University of Michigan law school told me, alluding to Merck’s lawsuit over the program: “Merck doesn’t have a constitutional right to sell its drugs to the government at the price that Merck would prefer.”

The companies uniformly characterize the program in their legal filings as government price-setting, as if the companies are powerless victims of an industrial dictatorship.

The truth is that in the lengthy negotiations, they’ll have every opportunity to make their case for a higher price, by citing their research and development costs, the exceptional value of their product, its uniqueness as a treatment, and so on.

One common claim in the lawsuits is that the negotiations, by reducing the manufacturers’ profits, will sap their interest in innovative research and development, in part because the returns from R&D will become so meager.

This argument is based on the industry’s own estimate that bringing a new drug to market costs more than $1 billion, in part because most drug development projects fail.

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That estimate has been challenged for years as immensely inflated. But it remains a key element in the industry’s pushback against the negotiation program.

The drug makers got academic support from economist Tomas Philipson of the University of Chicago, a former top economic advisor to President Trump.

Philipson estimated in 2021 that the negotiation proposal and other features of the Inflation Reduction Act would lead to 135 fewer new drugs through 2039 and the loss of more than 330 million life-years for Americans — an average of one year for every man, woman and child, or “about 31 times larger than from COVID-19 to date” (that is, through November 2021).

If that sounds unduly alarmist to you, then you’re on the same page as the Congressional Budget Office, which calculated that the drug-pricing provisions in the Inflation Reduction Act would reduce the number of new drugs brought to market by one in the first decade, four more in the decade after that, and five more in the third decade. Meanwhile, 1,300 new drugs would be introduced over that 30-year span.

Nor does that cover the question of which new drugs might fall by the wayside. The likelihood is that drug makers, if they’re truly feeling pinched by lower profits, would be more discerning about drugs with the least prospects for success and the smallest potential markets. Those with truly superior potential would still make it through the R&D gauntlet.

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Another issue raised by the drug-pricing initiatives is how drug companies spend the money they have. It doesn’t go mostly, or even largely, to R&D. As the Democratic staff of the House Oversight and Reform Committee reported in December 2021, the largest drug companies spent more on dividends and stock buybacks ($578 billion) than R&D ($522 billion) from 2016 through 2020.

“A significant portion” of the R&D spending, the staff determined, went not to the development of new drugs, but toward efforts to “extend market monopolies, support the companies’ marketing strategies, and suppress competition,” including insignificant “enhancements” of existing drugs aimed at getting a few years more protection against competition from biosimilar products.

In a sense, nothing the drug industry is saying by parading conjectures about the downside of lower drug prices before judges or the public is new. As I reported earlier, industry always claims that every regulatory initiative will hamper innovation and raise consumer costs and harm millions of innocent civilians.

In this case, the public remains fully in favor of lower drug prices, however they come about. Maybe that shows that they’ve finally gotten wise to the PR persiflage of Big Pharma.

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How Poshmark Is Trying to Make Resale Work Again

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How Poshmark Is Trying to Make Resale Work Again

Lauren Eager got into thrifting in high school. It was a way to find cheap, interesting clothes while not contributing to the wastefulness of fast fashion.

In 2015, in her first year of college, she downloaded the app for Poshmark, a kind of Instagram-meets-eBay resale platform. Soon, she was selling as well as buying clothes.

This was the golden age of online reselling. In addition to Poshmark, companies like ThredUp and Depop had sprung up, giving a second life to old clothes. In 2016, Facebook debuted Marketplace. Even Goodwill got into the action, starting a snazzy website.

The platforms tapped into two consumer trends: buying stuff online and the never-gets-old delight of snagging a gently used item for a fraction of the original cost. During the Covid-19 pandemic, as people cleaned out their closets, enthusiasm for reselling intensified. It was so strong that Poshmark decided to go public. On the day of its initial public offering in January 2021, the company’s market value peaked at $7.4 billion, roughly the same as PVH’s, the company that owns Calvin Klein and Tommy Hilfiger, at the time.

Then, the business of old clothes started to fray.

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Using the Poshmark app, Ms. Eager and others said, started to feel like trying to find something in a messy closet. The app was cluttered with features that did not work or that she did not use, and it felt “spammy,” she said, sending too many push notifications.

Many platforms found selling used items hard to scale. Now, online resellers are trying to recalibrate. Last year, ThredUp decided to exit Europe and focus on selling in the United States. Trove, a company that helps brands like Canada Goose and Steve Madden resell their goods, purchased a competitor, Recurate. The RealReal, a luxury consignor, appointed a new chief executive as the company tried to improve profitability.

Poshmark is undergoing perhaps the biggest reinvention. In 2023, Naver, South Korea’s biggest search engine as well as an online marketplace, bought the company in a deal valued at $1.6 billion, less than half its IPO price.

Something of a mash-up of Google and Amazon, Naver is betting it can rebuild Poshmark, which has 130 million active users, with the same technology that made Naver dominant in its own country.

It may also help breathe new life into the resale market. Analysts think the resale fashion market still has room to grow in the United States, with revenue expected to increase 26 percent to $36.3 billion by 2028, according to the retail consultancy firm Coresight Research.

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New legislation in California could help. The law, passed last year, requires brands and retailers that operate in the state and generate at least $1 million to set up a “producer responsibility organization” to collect and then reuse, repair or recycle its products. Resale platforms like ThredUp and Poshmark could be in a position to help brands carry out that mandate.

At the moment, though, Naver’s focus for Poshmark is more basic: Make it a better place to sell and shop. The company has the “operating know-how” to do that, said Philip Lee, a founder of the media outlet The Pickool, which covers both South Korean and U.S. tech companies.

“They’re trying to renovate Poshmark and then expand the market share,” he said.

Poshmark, which is based in Redwood City, Calif., was founded in 2011 by Manish Chandra, an entrepreneur and former tech executive, and three others. In trying to expand, Poshmark faced a problem common to resellers: Capturing the excitement of the secondhand-shopping treasure hunt while not frustrating buyers with an endless scroll. The company knew it needed better search, as well as interactive elements that gave people more reasons to come beyond paying $19 for a J. Crew sweater.

For its part, Naver was looking for ways to push beyond South Korea, where its commerce and search businesses were already mature. The growing online resale market in the United States presented an opportunity, and also gave the company access to the largest consumer market in the world.

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Commerce is a big growth engine for us,” Namsun Kim, Naver’s chief financial officer, said. And the peer-to-peer sector, where users sell to one another, was still in its infancy, with room to expand. But, Mr. Kim added, “it’s a more challenging segment, and that’s why it’s harder for a lot of the larger players to enter.”

There are two common business models for resale: peer-to-peer and consignment. With consignment, a platform collects and redistributes physical goods. Poshmark uses the peer-to-peer model, which relies on scores of people — many of them novices — haggling over prices and then mailing items to one another. This decentralization can be a headache for brands, which like to maintain a certain level of control of their products. And platforms like Poshmark must make buyers comfortable with trusting the sellers on their site.

Before the Naver purchase, it was difficult to push through needed technological changes, said Vanessa Wong, the vice president of product at Poshmark.

“I would always talk to my engineers and ask, ‘What if we do this or do that?’ They’re like, ‘That’s hard. The effort’s really high,’” Ms. Wong said.

Naver’s purchase offered both the investment and the expertise to pull off the changes. Founded in 1999, the company is everywhere in South Korea.

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“We are not just a simple search technology or A.I. service,” said Soo-yeon Choi, the chief executive of Naver, whose headquarters are near Seoul. The company, she said, “alleviates the frustrations of people, which is what is needed to help growth.”

Search built Naver “into the massive power that they are in Korea,” said Mr. Chandra, who stayed on as chief executive after Naver’s purchase. It was the top priority when the company bought Poshmark.

Several new elements for users and sellers have been introduced. With a tool called Posh Lens, users can take a photo of an item and, using Naver’s machine-learning technology, the site populates listings that are the same or similar to the shoe or tank top that they’re searching for. A paid ad feature for sellers called “Promoted Closet,” pushes listings higher on customer feeds.

Poshmark also introduced live shows, some of which are themed, to draw in the TikTok generation and increase engagement. One party auctioned off clothing previously worn by South Korean celebrities, a connection that was made with the help of Naver.

Still, the resale market is going through growing pains and has not quite found its footing since the height of the pandemic. It’s not clear whether the changes taking place at Poshmark will be enough. In May, Mr. Kim, Naver’s finance chief, said in an earnings call that Poshmark’s profitability was improving, but by November, the company was cautioning that growth had slowed because of weakness in the peer-to-peer resale market in North America.

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The company has already done some backpedaling on unpopular decisions.

In October, Poshmark introduced a new fee structure, which increased costs for buyers. Sellers, fearing that higher costs would make consumers bolt, revolted. Within weeks, the company scrapped the new fee structure.

And there are still user headaches: tags and keywords that help users find what they’re looking for can be miscategorized. Sellers sometimes tag their products incorrectly to get more eyeballs on their less popular products. (Hard-to-offload Amazon leggings, for example, may be listed as Free People apparel.)

The company is beta testing changes with its frequent sellers — people like Alex Mahl, who sells thousands of dollars in apparel on the site each year. And within dedicated Facebook groups related to Poshmark, there’s a lot of chatter about the changes that sellers and buyers would still like to see.

“The only way for it to do well is there’s going to be constant changes,” Ms. Mahl said about the tweaks on Poshmark. “If you were just on an app that never changed — one, it would be boring, and two, the opportunity to just do better wouldn’t be there.”

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One recent morning, Ms. Eager, the seller who joined Poshmark back in college, was pleasantly surprised to find that the app had some new features she actually liked. She snapped a photo of her Aerie gray tank top with Posh Lens. Within seconds, the app populated listings of similar products. It was so much better than conjuring up the adjectives needed to describe it.

“Love it,” Ms. Eager exclaimed.

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When receipts of home renovations are lost, is the tax break gone too?

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When receipts of home renovations are lost, is the tax break gone too?

Dear Liz: I have sold my family home recently after almost 50 years. I had done lots of improvements throughout those years. Due to a fire 15 years ago, all the documentation for these improvements has been destroyed. How do I document the improvements for the capital gains tax calculation?

Answer: As you probably know, you can exclude $250,000 of capital gains from the sale of a principal residence as long as you own and live in the home at least two of the previous five years. The exclusion is $500,000 for a couple.

Once upon a time, that meant few homeowners had to worry about capital gains taxes on the sale of their home. But the exclusion amounts haven’t changed since they were created in 1997, even as home values have soared. Qualifying home improvements can be used to increase your tax basis in the home and thus decrease your tax bill, but the IRS probably will demand proof of those changes should you be audited.

You could ask any contractors you used who are still in business if they will provide written verification of the work they performed, suggests Mark Luscombe, principal analyst for Wolters Kluwer Tax & Accounting. You also could check your home’s history with your property tax assessor to see if its assessment was adjusted to reflect any of the improvements.

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At a minimum, prepare a list from memory of the improvements you made, including the year and the approximate cost. If you don’t have pictures of the house reflecting the changes, perhaps friends and relatives might. This won’t be the best evidence, Luscombe concedes, but it might get the IRS to accept at least some increase in your tax basis.

If you’re a widow or widower, there’s another tax break you should know about. At least part of your home would have gotten a step-up in tax basis if you were married and your co-owner spouse died. In most states, the half owned by the deceased spouse would get a new tax basis reflecting the home’s current market value. In community property states such as California, both halves of the house get this step-up. A tax pro can provide more details.

Other homeowners should take note of the importance of keeping good digital records. While documents may not be lost in a fire, they may be misplaced, accidentally discarded or (in the case of receipts) so faded they’re illegible. To make sure documents are available when you need them, consider scanning or taking photographs of your records and keeping multiple copies, such as one set in your computer and another in a secure cloud account.

When an employee is misclassified as contractor

Dear Liz: A parent recently wrote to you about a son who was being paid as a contractor. I know someone else who got a job that did not “take out taxes from his paycheck.” Such workers believe they are pocketing more money, but unfortunately, too many do not know about the nature of withholding. They only learn if they choose to file for their expected refund, but instead discover an exorbitant tax liability that a paycheck-to-paycheck worker cannot pay.

The sad fact is that many of these employers improperly classify their workers, who are truly employees, as independent contractors! And they do this to avoid paying their own portion of Social Security and unemployment taxes and also workers compensation insurance.

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If workers believe that they have been misclassified (the IRS website provides all criteria), they can file IRS Form SS-8 and Form 8919, which will allow them to pay only their allocated half of their Social Security taxes. Hopefully the IRS will then contact these employers to correct their wrong classifications. And finally, it should be a law that, when hired, all true independent contractors should be given a clear form (not fine print on their employment agreements) that informs them of their status and the need to make estimated tax payments.

Answer: A big factor in determining whether a worker is an employee or contractor is control. Who controls what the worker does and how the worker does the job? The more control that’s in the employer’s hands, the more likely the worker is an employee.

However, the IRS notes that there are no hard and fast rules and that “factors which are relevant in one situation may not be relevant in another.”

The form you mentioned, IRS Form SS-8, also can be filed by any employer unsure if a worker is properly classified.

Liz Weston, Certified Financial Planner®, is a personal finance columnist. Questions may be sent to her at 3940 Laurel Canyon, No. 238, Studio City, CA 91604, or by using the “Contact” form at asklizweston.com.

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Inside Elon Musk’s Plan for DOGE to Slash Government Costs

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Inside Elon Musk’s Plan for DOGE to Slash Government Costs

An unpaid group of billionaires, tech executives and some disciples of Peter Thiel, a powerful Republican donor, are preparing to take up unofficial positions in the U.S. government in the name of cost-cutting.

As President-elect Donald J. Trump’s so-called Department of Government Efficiency girds for battle against “wasteful” spending, it is preparing to dispatch individuals with ties to its co-leaders, Elon Musk and Vivek Ramaswamy, to agencies across the federal government.

After Inauguration Day, the group of Silicon Valley-inflected, wide-eyed recruits will be deployed to Washington’s alphabet soup of agencies. The goal is for most major agencies to eventually have two DOGE representatives as they seek to cut costs like Mr. Musk did at X, his social media platform.

This story is based on interviews with roughly a dozen people who have insight into DOGE’s operations. They spoke to The Times on the condition of anonymity because they were not authorized to speak publicly.

On the eve of Mr. Trump’s presidency, the structure of DOGE is still amorphous and closely held. People involved in the operation say that secrecy and avoiding leaks is paramount, and much of its communication is conducted on Signal, the encrypted messaging app.

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Mr. Trump has said the effort would drive “drastic change,” and that the entity would provide outside advice on how to cut wasteful spending. DOGE itself will have no power to cut spending — that authority rests with Congress. Instead, it is expected to provide recommendations for programs and other areas to cut.

But parts of the operation are becoming clear: Many of the executives involved are expecting to do six-month voluntary stints inside the federal government before returning to their high-paying jobs. Mr. Musk has said they will not be paid — a nonstarter for some originally interested tech executives — and have been asked by him to work 80-hour weeks. Some, including possibly Mr. Musk, will be so-called special government employees, a specific category of temporary workers who can only work for the federal government for 130 days or less in a 365-day period.

The representatives will largely be stationed inside federal agencies. After some consideration by top officials, DOGE itself is now unlikely to incorporate as an organized outside entity or nonprofit. Instead, it is likely to exist as more of a brand for an interlinked group of aspirational leaders who are on joint group chats and share a loyalty to Mr. Musk or Mr. Ramaswamy.

“The cynics among us will say, ‘Oh, it’s naïve billionaires stepping into the fray.’ But the other side will say this is a service to the nation that we saw more typically around the founding of the nation,” said Trevor Traina, an entrepreneur who worked in the first Trump administration with associates who have considered joining DOGE.

“The friends I know have huge lives,” Mr. Traina said, “and they’re agreeing to work for free for six months, and leave their families and roll up their sleeves in an attempt to really turn things around. You can view it either way.”

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DOGE leaders have told others that the minority of people not detailed to agencies would be housed within the Executive Office of the President at the U.S. Digital Service, which was created in 2014 by former President Barack Obama to “change our government’s approach to technology.”

DOGE is also expected to have an office in the Office of Management and Budget, and officials have also considered forming a think tank outside the government in the future.

Mr. Musk’s friends have been intimately involved in choosing people who are set to be deployed to various agencies. Those who have conducted interviews for DOGE include the Silicon Valley investors Marc Andreessen, Shaun Maguire, Baris Akis and others who have a personal connection to Mr. Musk. Some who have received the Thiel Fellowship, a prestigious grant funded by Mr. Thiel given to those who promise to skip or drop out of college to become entrepreneurs, are involved with programming and operations for DOGE. Brokering an introduction to Mr. Musk or Mr. Ramaswamy, or their inner circles, has been a key way for leaders to be picked for deployment.

That is how the co-founder of Loom, Vinay Hiremath, said he became involved in DOGE in a rare public statement from someone who worked with the entity. In a post this month on his personal blog, Mr. Hiremath described the work that DOGE employees have been doing before he decided against moving to Washington to join the entity.

“After 8 calls with people who all talked fast and sounded very smart, I was added to a number of Signal groups and immediately put to work,” he wrote. “The next 4 weeks of my life consisted of 100s of calls recruiting the smartest people I’ve ever talked to, working on various projects I’m definitely not able to talk about, and learning how completely dysfunctional the government was. It was a blast.”

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These recruits are assigned to specific agencies where they are thought to have expertise. Some other DOGE enrollees have come to the attention of Mr. Musk and Mr. Ramaswamy through X. In recent weeks, DOGE’s account on X has posted requests to recruit a “very small number” of full-time salaried positions for engineers and back-office functions like human resources.

The DOGE team, including those paid engineers, is largely working out of a glass building in SpaceX’s downtown office located a few blocks from the White House. Some people close to Mr. Ramaswamy and Mr. Musk hope that these DOGE engineers can use artificial intelligence to find cost-cutting opportunities.

The broader effort is being run by two people with starkly different backgrounds: One is Brad Smith, a health care entrepreneur and former top health official in Mr. Trump’s first White House who is close with Jared Kushner, Mr. Trump’s son-in-law. Mr. Smith has effectively been running DOGE during the transition period, with a particular focus on recruiting, especially for the workers who will be embedded at the agencies.

Mr. Smith has been working closely with Steve Davis, a collaborator of Mr. Musk’s for two decades who is widely seen as working as Mr. Musk’s proxy on all things. Mr. Davis has joined Mr. Musk as he calls experts with questions about the federal budget, for instance.

Other people involved include Matt Luby, Mr. Ramaswamy’s chief of staff and childhood friend; Joanna Wischer, a Trump campaign official; and Rachel Riley, a McKinsey partner who works closely with Mr. Smith.

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Mr. Musk’s personal counsel — Chris Gober — and Mr. Ramaswamy’s personal lawyer — Steve Roberts — have been exploring various legal issues regarding the structure of DOGE. James Burnham, a former Justice Department official, is also helping DOGE with legal matters. Bill McGinley, Mr. Trump’s initial pick for White House counsel who was instead named as legal counsel for DOGE, has played a more minimal role.

“DOGE will be a cornerstone of the new administration, helping President Trump deliver his vision of a new golden era,” said James Fishback, the founder of Azoria, an investment firm, and confidant of Mr. Ramaswamy who will be providing outside advice for DOGE.

Despite all this firepower, many budget experts have been deeply skeptical about the effort and its cost-cutting ambitions. Mr. Musk initially said the effort could result in “at least $2 trillion” in cuts from the $6.75 trillion federal budget. But budget experts say that goal would be difficult to achieve without slashing popular programs like Social Security and Medicare, which Mr. Trump has promised not to cut.

Both Mr. Musk and Mr. Ramaswamy have also recast what success might mean. Mr. Ramaswamy emphasized DOGE-led deregulation on X last month, saying that removing regulations could stimulate the economy and that “the success of DOGE can’t be measured through deficit reduction alone.”

And in an interview last week with Mark Penn, the chairman and chief executive of Stagwell, a marketing company, Mr. Musk downplayed the total potential savings.

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“We’ll try for $2 trillion — I think that’s like the best-case outcome,” Mr. Musk said. “You kind of have to have some overage. I think if we try for two trillion, we’ve got a good shot at getting one.”

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