Mangione pleads guilty in federal case over UnitedHealthcare CEO's killing

Luigi Mangione pleaded guilty on Friday to federal charges in the December 2024 killing of UnitedHealthcare CEO Brian Thompson, admitting in a Manhattan courtroom that he shot the executive outside an investor conference.

Mangione, 28, told the court he had tracked Thompson to the event and fired the fatal shot. Thompson's wife, Paulette, was present in the courtroom and appeared visibly emotional as the plea was entered.

Following the plea, defense attorney Karen Friedman Agnifilo said her client had "accepted full responsibility" for Thompson's death. She argued that Mangione is being prosecuted twice for the same act, noting that he had already faced — and successfully fought off — terrorism charges and the death penalty in earlier proceedings.

Agnifilo said Mangione's actions stemmed from years of severe pain after a back injury and his struggles navigating the U.S. healthcare system. She described the killing as a "single tragic event" and said New York's double jeopardy protections should bar the separate state prosecution.

U.S. Attorney Jamie McDonald said Mangione pleaded guilty "open," meaning there is no plea agreement and no concessions from prosecutors. McDonald said the office is free to seek the maximum penalty, which could mean life in prison.

Mangione is scheduled to be sentenced on December 18. He faces a separate murder case in New York state, which his legal team now wants dismissed under the state's double jeopardy law.

The shooting, captured on surveillance video, showed a masked gunman firing at Thompson from behind. Police said the ammunition bore the words "delay," "deny," and "depose," a phrase critics use to describe insurance company tactics. Mangione's writings, which authorities said criticized health insurers, turned the case into a flashpoint in the national debate over the industry.

Mangione was arrested five days after the killing at a McDonald's in Pennsylvania. He was never a UnitedHealthcare customer, according to police and the company.

Thompson, 50, had led UnitedHealthcare since 2021 and had worked at its parent company for two decades. He is survived by his wife and two sons.