Numerous studies have reported an increase in hate speech on X (formerly Twitter) in the months immediately following Elon Musk's acquisition of the platform on October 27th, 2022; relatedly, despite Musk's pledge to "defeat the spam bots," a recent study reported no substantial change in the concentration of inauthentic accounts. However, it is not known whether any of these trends endured. We address this by examining material posted on X from the beginning of 2022 through June 2023, the period that includes Musk's full tenure as CEO. We find that the increase in hate speech just before Musk bought X persisted until at least May of 2023, with the weekly rate of hate speech being approximately 50% higher than the months preceding his purchase, although this increase cannot be directly attributed to any policy at X. The increase is seen across multiple dimensions of hate, including racism, homophobia, and transphobia. Moreover, there is a doubling of hate post "likes," indicating increased engagement with hate posts. In addition to measuring hate speech, we also measure the presence of inauthentic accounts on the platform; these accounts are often used in spam and malicious information campaigns. We find no reduction (and a possible increase) in activity by these users after Musk purchased X, which could point to further negative outcomes, such as the potential for scams, interference in elections, or harm to public health campaigns. Overall, the long-term increase in hate speech, and the prevalence of potentially inauthentic accounts, are concerning, as these factors can undermine safe and democratic online environments, and increase the risk of offline harms.