UnitedHealthcare CEO Shooting

On December 4, 2024, [Brian Thompson](https://en.wikipedia.org/wiki/Killing_of_Brian_Thompson) — the 50-year-old CEO of UnitedHealthcare, the largest private health insurer in the United States — was allegedly shot and killed outside the New York Hilton Midtown hotel in Midtown Manhattan at approximately 6:45 a.m. According to law enforcement, Thompson was walking toward an annual investor conference when a masked gunman approached from behind and fired multiple rounds, striking him in the back and leg. The shooter then fled northward on an e-bike through Central Park, where a backpack was later found abandoned. Shell casings recovered at the scene were inscribed with the words "delay," "deny," and "depose" — a reference to a 2010 book by Rutgers law professor Jay Feinman documenting how insurance companies profit by delaying, denying, and defending against legitimate claims. The weapon was allegedly fitted with a 3D-printed homemade suppressor, and the killing was captured in full by hotel surveillance cameras.

UnitedHealthcare is the health insurance division of UnitedHealth Group, at the time the most valuable health company in the world with revenues exceeding $370 billion annually. The company covered approximately 50 million Americans. Thompson had led UnitedHealthcare since 2021. In the months before his death, the company had faced escalating public criticism for algorithmic systems that allegedly denied medical claims at unusually high rates, including care for cancer patients and individuals with terminal diagnoses. The shooting landed at the epicenter of a long-simmering national debate about private health insurance practices and patient rights.

A five-day national manhunt followed. Newly appointed NYPD Commissioner Jessica Tisch led the public-facing investigative effort, coordinating with the FBI and NYPD Chief of Detectives Joseph Kenny as detectives retraced the suspect's movements through Manhattan's extensive camera network. According to court records, investigators determined that the gunman had arrived in New York City by bus from Atlanta on November 24, 2024, and checked into a hostel on West 94th Street on November 25 under the name "Mark Rosario" — allegedly a false identity. On the morning of the shooting, he was captured on camera purchasing a coffee at a Starbucks near the hotel. DNA from a water bottle and a KIND bar wrapper discarded near the Starbucks were later used to help identify the suspect. NYPD and the FBI offered a combined $10,000 reward and circulated high-resolution surveillance still images nationally.

On December 9, 2024, a customer at a McDonald's in Altoona, Pennsylvania recognized the suspect from the widely-shared photos and alerted staff, who called police. Luigi Nicholas Mangione, then 26 years old, was arrested at the restaurant. Bullets from Mangione's bag were subsequently matched to casings recovered at the crime scene, and fingerprint analysis allegedly linked him to physical evidence recovered near the hotel. A 3D-printed ghost gun with a suppressor was also recovered, as well as a fake New Jersey ID in the name "Mark Rosario," a Greyhound bus ticket purchased under a false name, and a multi-page handwritten manifesto.

Mangione was valedictorian of his 2016 graduating class at the Gilman School, a prestigious all-boys prep school in Baltimore, Maryland. He subsequently graduated from the University of Pennsylvania in 2020 with both a bachelor's and a master's degree in engineering. He came from a prominent Baltimore family; his grandfather had founded Lorien Healthcare, a Maryland nursing home chain, and his cousin Nino Mangione serves in the Maryland House of Delegates. Mangione had no prior criminal record. According to public records and online posts, he had suffered from debilitating back pain and underwent spinal surgery in late 2023, after which he reportedly severed contact with friends and family. His handwritten manifesto, portions of which were disclosed in court proceedings, characterized the U.S. health insurance industry as "an unneeded, parasitic influence on our society" and framed the alleged killing as a political act, naming UnitedHealthcare by name and alleging "abuse, negligence, and greed" as motivation. Police noted the manifesto bore similarities in tone to the writings of Ted Kaczynski.

The public reaction was unlike almost any homicide case in recent American history. While law enforcement officials and political figures condemned the murder, social media was flooded with expressions of sympathy and even admiration for the suspect. The divergence between official condemnation and popular sentiment reflected deep anger at the American healthcare system and its denial-of-claims practices.

On the legal front, [a Manhattan grand jury indicted Mangione on 11 counts on December 17, 2024](https://www.cnn.com/2024/12/17/us/luigi-mangione-ceo-shooting/index.html), including first-degree murder charged as an act of terrorism under New York law. He was extradited to New York from Pennsylvania on December 19, and arraigned on December 23, 2024, pleading not guilty to all charges. In April 2025, a federal grand jury separately indicted Mangione on charges including murder through use of a firearm, stalking resulting in death, and related federal counts — charges that originally carried the potential for the federal death penalty. He pleaded not guilty to all federal charges on April 25, 2025. In September 2025, a New York state judge dismissed the terrorism-related first-degree murder count, according to court records, leaving second-degree murder as the lead charge in the state case. On January 30, 2026, federal Judge Analisa Torres dismissed the death-eligible murder charge, ruling that the government had failed to adequately allege the required racketeering nexus. The New York State murder trial is scheduled to begin June 8, 2026. Federal jury selection in the remaining stalking counts is scheduled for September 2026.

Mangione is represented by defense attorneys Thomas Dickey and Marc Agnifilo; Karen Friedman Agnifilo, known for her prior work as a senior prosecutor, joined the defense team. The Manhattan District Attorney's office, led by Alvin Bragg, is handling the state prosecution. Mangione has pleaded not guilty to all charges and is charged with, but has not been convicted of, any crime in connection with the death of Brian Thompson.

Arrest & Charges

[Luigi Mangione was arrested on December 9, 2024, in Altoona, Pennsylvania](https://apnews.com/article/unitedhealthcare-ceo-shot-killed-brian-thompson-1e3b449dd9ed5fabeb2ad592fde91575), five days after the shooting. He faces criminal proceedings in two separate jurisdictions — New York State and federal court — and was extradited to New York to face state charges.

State Proceedings (New York)

[A Manhattan grand jury indicted Mangione on 11 counts on December 17, 2024](https://www.cnn.com/2024/12/17/us/luigi-mangione-ceo-shooting/index.html), including first-degree murder in furtherance of terrorism, second-degree murder, and weapons charges. He pleaded not guilty at his December 23 arraignment. On September 16, 2025, Judge Gregory Carro dismissed the two terrorism-related murder charges, finding them legally insufficient; second-degree murder and remaining counts continue. A three-week suppression hearing concluded December 18, 2025, with the defense seeking to exclude the ghost gun, silencer, and handwritten notebook recovered at arrest; Judge Carro is expected to rule in May 2026. The state trial is scheduled to begin June 8, 2026.

Federal Proceedings

Federal prosecutors charged Mangione in December 2024 with murder through use of a firearm — a death-eligible offense — along with two stalking counts and a related firearms charge. A federal grand jury issued a formal indictment in April 2025; Mangione pleaded not guilty on April 25, 2025. On January 30, 2026, U.S. District Judge Margaret Garnett dismissed the death-eligible murder count, ruling that stalking does not qualify as a predicate crime of violence under the applicable federal statute. On February 27, 2026, prosecutors confirmed they would not appeal. Two stalking counts remain, each carrying a maximum of life imprisonment without parole. The federal trial is scheduled with jury selection September 8, 2026, and opening statements October 13, 2026.

Current Status

Mangione has pleaded not guilty to all charges and is not known to be in plea negotiations. He will not face the death penalty — New York abolished capital punishment in 2004, and the federal death-eligible charges have been dismissed and will not be appealed.