The man accused of gunning down UnitedHealth CEO Brian Thompson — Luigi Mangione — walked into a courtroom on August 14 and pleaded guilty to his federal criminal charges.
Mangione, 28, has been juggling both federal and state indictments. This plea agreement sidesteps a federal trial entirely, and could also open the door for him to push for the dismissal of New York state murder charges, potentially delaying the upcoming state trial.
Back in January, a judge tossed out the federal murder and firearm counts against Mangione, which eliminated any chance of the death penalty at the federal level. But if he’s convicted on the remaining two federal stalking charges, he could still spend the rest of his life behind bars without parole.
On the state side, Mangione was facing a laundry list of charges including second-degree murder, illegal weapon possession, and carrying fake ID. That state trial was slated for September 8. A conviction on second-degree murder would mean 25 years to life in prison.
On December 4, 2024, Thompson was shot and killed outside a Manhattan hotel. Mangione allegedly waited for him to arrive, fired multiple shots, then bolted from the scene. Five days later, he was arrested in Pennsylvania.
Police also recovered a 3D-printed handgun, a silencer, a U.S. passport, four fake IDs, and a two-page handwritten manifesto from Mangione’s backpack. NYPD Chief of Detectives Joseph Kenny noted that the manifesto revealed part of the suspect’s intent. It read, “Violence is the way to solve problems. These parasites (corporate executives) deserve what they get. I apologize for the trauma I caused, but this had to be done.”
At the murder scene in Manhattan, police also found bullet casings inscribed with the words “delay,” “defy,” and “depose” — a pointed nod to the book Delay, Deny, Defend, published 14 years earlier, which criticized insurance companies’ tactics for refusing claims.
This case has thrust America’s commercial healthcare system back into the spotlight, sparking fierce debate. Many people didn’t hold back, posting sarcastic and even gleeful comments to vent their anger at insurers for denying claims and at the industry’s greed. Robert Pape, a political violence expert at the University of Chicago, pointed out that Americans are increasingly accepting violence as a way to settle civil disputes.
According to data from state and federal regulators, more than 200 million Americans carry commercial health insurance, but roughly 1 in 7 claims get denied. Faced with powerful insurance companies, many people simply give up: only 0.1% ever file an appeal.
UnitedHealth is part of UnitedHealth Group. Two days after Thompson was killed, then-CEO Andrew Witty defended the company’s claim-denial practices in a leaked internal video , urging employees to resist outside pressure, saying it could make the entire healthcare system unsustainable. The video circulated widely on X, further inflaming public anger.
UnitedHealth hasn’t publicly disclosed its specific claim denial statistics, but numerous lawsuits paint a telling picture. Its tactics include prior authorization requirements, collusion with healthcare providers, and unilaterally defining what counts as “medically unnecessary” — leading to heart surgery patients being hit with extra bills and brain surgery patients being sent home the very same day. Patients also frequently find themselves bounced back and forth between hospitals and insurers, missing claim deadlines in the process.
In April 2021, Thompson was named CEO of UnitedHealth, after nearly 20 years with the group. Under his leadership, company profits climbed from $12 billion in fiscal 2021 to $16 billion in 2023, and his own compensation rose to $10.2 million.
Meanwhile, Mangione, 26, has been hailed by some as a Robin Hood-style folk hero — a nod to the 12th-century English legend who robbed the rich to give to the poor.
After the case broke, Mangione’s family, classmates, and colleagues all expressed shock and disbelief: he was born with a silver spoon, attended elite schools, and had a promising future — now all thrown away. According to his roommate Martin (R.J. Martin) from their remote-work days in Hawaii, Mangione had long suffered from spondylolisthesis, which worsened after surfing in Hawaii, leading to surgery in 2023. The long bedridden recovery left him deeply depressed. In Martin’s recollection, although Mangione was athletic, he never showed any violent tendencies.
According to Maryland’s Baltimore Banner, Mangione is of Italian descent. His grandfather Nicholas Mangione was a self-made real estate developer whose local holdings included nursing home facilities and two country clubs.
In high school, he often talked about his dream of developing his own video game. By the time he graduated college in 2020, he had earned both a master’s in computer and information science and a master’s in mathematics from the University of Pennsylvania. For the past four years, Mangione had been working as a data engineer at the California-based online car retailer TrueCar Inc.
Mangione describes himself as an anti-capitalist who doesn’t align with any political party. Despite possible mental health struggles, he frequently posted travel photos and gym workouts on social media, projecting a sunny, optimistic image.
On Goodreads, his profile shows a collection of nearly 300 books, with themes ranging from mental illness to psychedelic science. On X, he follows about 75 accounts, including prominent scholars and public figures like Edward Snowden, RFK Jr., and the author of the bestseller The Anxious Generation. Mangione also regularly posted about artificial intelligence and psychedelics.