New York, United States:

US authorities on Tuesday charged the man suspected of gunning down a health insurance CEO in New York earlier this month with murder, including a charge of second-degree murder “as an act of terrorism.”

Mangione, 26, is accused of shooting UnitedHealthcare chief executive Brian Thompson on a Manhattan street on December 4, triggering a nationwide manhunt that ended last week when he was spotted at a Pennsylvania McDonald’s.

The former data engineer remains jailed in that state as he fights efforts to extradite him to New York to face charges there over the killing, which brought into focus widespread public anger against the US health care system.

Mangione “is charged with one count of murder in the first degree and two counts of murder in the second degree, including one count of murder in the second degree as an act of terrorism,” said Manhattan district attorney Alvin Bragg.

Bragg said the terrorism charge was included because the shooting met the prerequisites for such a determination under New York law.

“In its most basic terms, this was a killing that was intended to evoke terror and we’ve seen that reaction,” he said. “This was not an ordinary killing.”

The maximum penalty for the murder charges Mangione faces is life in prison without parole, Bragg said.

The suspect was also charged with several crimes related to his possession of a weapon, which authorities said was a 3D-printed “ghost gun.”

“We allege he… took out a nine-millimeter 3D-printed ghost gun equipped with a 3D-printed suppressor and shot (Thompson) once in the back and once in the leg,” said Bragg.

“These weapons are increasingly proliferating throughout New York City and the entire country. Evolving technology will only make this problem worse,” he said.

“Last year, over 80 ghost guns and ghost gun parts were recovered in Manhattan alone.”

‘Shocking and appalling’

In the wake of Thompson’s killing, many social media users have lionized Mangione, with some even calling for further killings of other CEOs.

Jessica Tisch, the New York City police commissioner, criticized members of the public who had praised the murder.

“In the nearly two weeks since Mr Thompson’s killing, we have seen a shocking and appalling celebration of cold-blooded murder,” said Tisch.

Mangione is due in Pennsylvania court on Thursday for a hearing on his extradition to New York.

Police say a “life-changing, life-altering” back injury may have motivated Mangione, although they added that there was “no indication” that he was ever a client of UnitedHealthcare.

When he was arrested, Mangione had a three-page handwritten text criticizing the US health care system.

Police have said that Mangione’s fingerprints matched those found near the crime scene, and that shell casings match the gun found on him when he was arrested.

Bragg said that the suspect traveled to New York on November 24 with the intention of murdering Thompson.

On December 4, he is alleged to have waited “for nearly an hour” outside the hotel where Thompson was shot early that morning.

“This was a frightening, well planned, targeted murder that was intended to cause shock and attention and intimidation,” said district attorney Bragg.

(Except for the headline, this story has not been edited by NDTV staff and is published from a syndicated feed.)

Luigi Mangione, 26, a suspect in the New York City killing of UnitedHealth executive Brian Thompson, poses for a booking photograph at State Correctional Institution (SCI) Huntingdon in Huntingdon, Pennsylvania, U.S. December 9, 2024. File
| Photo Credit: PA Department of Corrections

After Luigi Mangione made the difficult decision to undergo spinal surgery last year for chronic back pain, he became a proponent of the procedure that changed his life for the better.

He repeatedly posted on Reddit about his recovery and offered words of encouragement for people with similar conditions, telling them to push back against doctors who suggested they had to live with pain.

But notably absent from the posts are explicit concerns about corporate greed in the health insurance industry. Those appear to have surfaced only later: in a handwritten note found after Mr. Mangione was detained as a suspect in the killing of UnitedHealthcare CEO Brian Thompson.

That short document references “parasites” in the health care system and laments the power and profits of health insurers, according to law enforcement officials. During his first public words since his arrest in Pennsylvania, Mr. Mangione emerged from a patrol car shouting about an “insult to the intelligence of the American people” while sheriff’s deputies pushed him into a courthouse.

There’s no indication Mr. Mangione was ever insured by UnitedHealthcare, a senior New York City police official said in an interview Thursday (December 12, 2024) with NBC New York.

The killing has nonetheless prompted widespread speculation about whether he had a bad personal experience with the health care system. But after his 2023 surgery, Mr. Mangione’s Reddit posts suggest he was overwhelmingly pleased with the outcome and finally relieved of chronic pain. He encouraged others not to be frightened by horror stories of surgeries gone bad. He also referenced a backpacking trip to Asia earlier this year.

The 26-year-old Ivy League graduate appears to have stopped posting on social media roughly six months ago, around the time he lost touch with loved ones.

Family and friends expressed shock at news of Mr. Mangione’s arrest, but little information has emerged about his recent mental and physical health.

Mr. Mangione’s Reddit posts reference a spinal condition called spondylolisthesis, which occurs when a fracture causes a vertebra to slip out of alignment. It can result in severe pain if the bone puts pressure on spinal nerves.

The condition, which can originate in childhood or from an injury, started negatively impacting Mr. Mangione’s life in recent years, according to his social media posts.

After earning his bachelor’s and master’s degrees from the University of Pennsylvania, he worked at the Santa Monica-based car-buying website TrueCar until 2023 and lived in Hawaii for some time starting in January 2022. During a six-month stay at Surfbreak, a “co-living” space in Honolulu, Mr. Mangione’s back pain worsened in part because of a surfing incident.

Josiah Ryan, a spokesperson for the owner and founder of Surfbreak, R.J. Martin, said Mr. Mangione had expressed growing concerns about the pain. In addition to missing out on recreational activities and exercise, he was worried about how it could affect romantic relationships.

“That was definitely a theme in his time there,” Mr. Ryan said. “He wasn’t a big complainer. So, it wasn’t like he was bringing it up constantly. But the people who knew him knew this was a significant part of his life.”

In July 2023, Mr. Mangione wrote in a Reddit post that he had decided to get surgery.

“I got caught in this loop for a year, all the while putting my life on hold in my 20’s and damaging my nerves while I waffled on the decision. I have surgery scheduled in two weeks and I keep wondering why I was so afraid of it,” he wrote. According to his posts, the operation was a success.

An image posted to an X account linked to Mr. Mangione showed what appeared to be an X-ray of a metal rod and multiple screws inserted into his lower spine.

“Surgery was painful for the first couple days, but I was shocked that by day 7 I was on literally zero pain meds,” Mr. Mangione posted on Reddit in August 2023. “Obviously will be awhile until I get into rigorous activity, but it was way less of a big deal than I had anticipated.”

Medical experts say treating back pain is almost always a challenge. “In the gross majority of treatments, surgery is when everything else has failed to provide relief,” said Dr. Jason Pittman, co-director of the Spine Center at Boston’s Beth Israel Deaconess Medical Center. He said doctors generally try conservative treatments like physical therapy, injections or medications before surgery.

Even people with health insurance can face thousands of dollars in bills from a surgery depending on their deductible and other factors, though it’s unclear whether Mr. Mangione experienced any of those issues.

Experiencing chronic back pain can also significantly impact mental health, said Dr. Padma Gulur, a pain specialist with Duke Health. “If you have underlying mental health issues – anxiety, depression – your pain can be worse because you have way more suffering,” Ms. Gulur said. “But the second aspect is pain can push you into anxiety and depression.”

Little is known about Mr. Mangione’s mental state in recent months, but it appears he was withdrawing from close relationships. Since-deleted posts on X show a friend repeatedly reaching out and getting no response. His family reported him missing to San Francisco authorities in November, police said.

Earlier, while in college, Mr. Mangione posted on Reddit about experiencing severe brain fog and restless sleep. In a July 2018 post, he said his grades were suffering and he had considered dropping out of school. But ultimately, “staying in college has at least let me maintain some semblance of normality,” he wrote.

His last Reddit post is dated May 17, but other statements around that time suggest he wasn’t experiencing unexpected complications or renewed back pain. He appears to be advocating for the type of surgery he received months earlier.

He posted in early April about the gear he brought on a two-month backpacking trip through Asia that included some cross-country motorcycling, saying he had found “the perfect balance between minimalism and practicality.” In late April, he advised another Reddit user with a back problem to “keep trying different surgeons” and, if necessary, convey an inability to keep working.

“We live in a capitalist society,” he wrote. “I’ve found that the medical industry responds to these key words far more urgently than you describing unbearable pain and how it’s impacting your quality of life.”

Luigi Mangione, who was arrested for allegedly killing UnitedHealthcare CEO Brian Thompson, was never a client of the medical insurance company, a New York Police Department (NYPD) official said. According to the police, the 26-year-old Ivy League graduate may have killed the CEO due to the “size and influence” of the company, reported NBC.

Chief of Detectives Joseph Kenny said that Mangione was aware of the company holding its annual investor conference at a Manhattan hotel on December 4 – the day of the crime.

“We have no indication that he was ever a client of United Healthcare, but he does mention that it is the fifth largest corporation in the US, which would make it the largest healthcare organisation in the country. So that’s possibly why he targeted the company…He had prior knowledge that the conference was taking place on that date, at that location,” Kenny told NBC.

Mangione shot the UnitedHealthcare CEO Brian Thompson on December 4 and was since then on the run. The University of Pennsylvania grad led the police on a five-day manhunt, following which he was arrested from a McDonalds in Pennsylvania. He is currently in custody and is facing multiple charges, including murder. Mangione was denied bail at an extradition hearing at the Blair County Courthouse in Pennsylvania on Wednesday.

The suspect was reportedly arrested with a manifesto where he accused health insurance companies of putting corporate greed over the well-being of people – which led to theories that he may have killed the CEO over disappointment with the insurance provider. The police also reportedly found some of Mangione’s writings about wanting to use a gun to target a CEO of a big corporation.

The NYPD found a 3D-printed gun from Mangione – which matched three shell casings found at the crime scene. The 9mm shell casings reportedly had the words “delay”, “deny” and “depose” written across them on each bullet – which were the title of a book criticising the insurance industry.

Luigi Mangione, 26, a suspect in the New York City killing of UnitedHealth executive Brian Thompson, arrives for an extradition hearing at Blair County Court House in Hollidaysburg, Pennsylvania, U.S. December 10, 2024.
| Photo Credit: Reuters

The man charged with brazenly gunning down a top health insurance CEO in New York carried a handwritten manifesto of grievances against the industry, police said on Tuesday (December 10, 2024), giving a possible motive for the first time.

Luigi Mangione, 26, yelled and struggled with officers as he was led into court in Pennsylvania wearing an orange jumpsuit, for a hearing on extraditing him back to New York.

He is accused of murdering UnitedHealthcare chief executive Brian Thompson on a Manhattan street last week, triggering a nationwide manhunt that ended Monday when he was recognized at a McDonald’s restaurant in Altoona, Pennsylvania.

Mangione fought his extradition to New York, a complaint which Blair County prosecutor Peter Weeks described as creating “more hoops… to jump through”, and a judge denied him bail as the process continues.

The defense lawyers now have 14 days to submit motions against moving Mangione to New York, Weeks said.

The suspect, who attended the elite University of Pennsylvania and reportedly comes from a wealthy family, could be heard shouting “unjust” and “an insult to the intelligence of the American people” as officers bundled him out of a car and into court.

The revelation of a manifesto carried by Mangione appears to back up the theory that he was angered by the complex and at times dysfunctional US health care system.

“I had an opportunity to read the manifesto,” the New York Police Department’s Chief of Detectives Joseph Kenny said on the Good Morning America TV show.

“It’s handwritten. He does make some indication that he’s frustrated with the health care system in the United States.”

Kenny said Mangione decried how the US health care system is among the most expensive in the world and yet the country has a lower life expectancy than other developed nations.

“He was writing a lot about his disdain for corporate American and in particular the health care industry,” said Kenny.

The New York criminal complaint alleges Mangione was found with “written admissions about the crime” but contains no further detail.

Police have not confirmed reports the words “delay” and “deny” — language used by insurers to reject claims — were written on bullet casings found at the scene.

Suspect was ‘shaking’

Investigators interrogated Mangione over last week’s murder which triggered global headlines and sent shockwaves through the American business sector.

He appeared at a Pennsylvania court wearing a dark sweatshirt late Monday and was led inside by Altoona police, flanked by New York detectives.

Mangione was later charged in New York on suspicion of one count of murder, two counts of second-degree criminal possession of a weapon and other offenses.

He is next due to appear in court on December 23, and has yet to enter a plea.

The White House condemned the shooting

“Obviously, this is horrific. Violence to combat any sort of corporate greed is unacceptable,” Press Secretary Karine Jean-Pierre told a briefing when asked about the grievances aired by Mangione.

The suspect was apprehended by officers following a tip from staff at the McDonald’s, where he was found wearing a mask and a beanie while using a laptop, and gave officers a fake ID, charging documents show.

They then searched him and found what police called a “ghost gun” capable of firing 9mm rounds and equipped with a suppressor that could have been made on a 3D printer.

When officers asked if he had been to New York recently, Mangione “became quiet and started to shake,” according to the criminal complaint.

One of the fake IDs found was one used to check in to a Manhattan hostel ahead of the attack, police said.

Mangione appeared to have health issues, living with serious back pain and undergoing surgery for the condition last year, according to a New York Times report quoting friends.

A photo on what appeared to be one of his social media accounts featured an X-ray of a spine with a medical implant.

Luigi Mangione, a suspect in UnitedHealthcare CEO’s murder.

This undated photo provided by UnitedHealth Group shows UnitedHealthcare chief executive officer Brian Thompson. (AP Photo/UnitedHealth Group via AP)

UnitedHealthcare CEO Brian Thompson was killed Wednesday (December 4, 2024) morning in what investigators suspect was a targeted shooting outside a Manhattan hotel where the health insurer was holding an investor conference.

The killing was a “brazen, targeted attack,” Jessica Tisch, the New York City police commissioner said. New York Governor Kathy Hochul called it a “horrific and targeted shooting.”

Mr. Thompson, 50, was set to speak at an investor meeting when he was gunned down around 6,45 a.m. outside the New York Hilton Midtown by a shooter who fled on foot and then took an e-bike into Central Park, according to the New York Police Department.

Mr. Thompson was taken to a hospital but could not be saved. Police were still searching for the shooter as of late morning and no arrests had been made. Though officials said the attack appeared to be targeted, they did not yet have a motive for the shooting.

Mayor Eric Adams said police were reviewing evidence from the scene, including video. “It seems to be clearly targeted by an individual and we will apprehend that individual,” Mr. Adams said.

UnitedHealthcare is the insurance arm of the health care giant UnitedHealth Group Inc. The Minnetonka, Minnesota-based company was scheduled to have its annual meeting with investors in New York City to update Wall Street on the company’s direction and expectations for the coming year, according to a company media advisory. An announcement was made to attendees Wednesday (December 4, 2024) morning that the conference was ending early.

The Hilton is in a bustling part of Manhattan, a short walk from tourist sites such as the Museum of Modern Art and Rockefeller Center, and often dense with tourists and office workers on weekday mornings. The popular Rockefeller Center Christmas Tree lighting is set to take place Wednesday (December 4, 2024) evening.

Part of the block where the shooting took place was cordoned off with police tape, with a large contingent of police officers at the scene. Many security cameras are nearby. Mr. Thompson had served as CEO for more than three years and had been with the company since 2004.

Minnesota Gov. Tim Walz tweeted that the state is “sending our prayers to Brian’s family and the UnitedHealthcare team.” “This is horrifying news and a terrible loss for the business and health care community in Minnesota,” the Democrat wrote.

UnitedHealthcare is the largest provider of Medicare Advantage plans in the U.S. and manages health insurance coverage for employers and state-and federally funded Medicaid programs.