Mangione pleads not guilty to state charges in health insurance CEO killing

Luigi Mangione, the 26-year-old man accused of killing UnitedHealthcare CEO Brian Thompson in Manhattan earlier this month, pleaded not guilty on Monday to the state charges he is facing, including murder. 

Mangione’s not guilty plea comes after he was extradited late last week from Pennsylvania, where he was initially found and arrested, to New York, where the trial will be held. He is also facing four federal counts, including a charge of murder through use of a firearm, which could allow prosecutors to seek the death penalty. 

But while prosecutors have said the state and federal cases will progress on parallel tracks, the state trial is expected to happen first. The maximum sentence Mangione could receive if convicted in the state trial is life imprisonment without the possibility of parole. 

Prosecutors have accused Mangione of killing Thompson on Dec. 4 by New York Hilton Midtown as the CEO was set to address an annual investors meeting. Officials embarked on a five-day manhunt for the suspect, eventually tracking Mangione to a McDonald’s in Pennsylvania. 

Upon his arrest, authorities found Mangione carrying a gun that matched the one used in the shooting, a fake ID and a notebook railing against the health insurance industry and wealthy executives. The most significant charge that Mangione is facing in state court is murder as an act of terrorism. 

Karen Friedman Agnifilo, Mangione’s attorney, pushed back against the simultaneous state and federal cases against her client, calling it “highly unusual” and “very confusing” for someone to face charges in both jurisdictions at once. 

Thompson’s killing has received widespread condemnation but also sparked some backlash among some against the health care industry. Critics have pointed to instances of steep medical bills and denials of coverage as issues that motivate frustration with the industry. 

Thompson worked at UnitedHealthcare Group for 20 years and served as CEO of the insurance arm since 2021. 

The Associated Press contributed.