Luigi Mangione pleads not guilty to state charges in slaying of UnitedHealthcare CEO

NEW YORK ? The man accused of shooting UnitedHealthcare CEO Brian Thompson to death on a busy Manhattan street pleaded not guilty Monday to state murder and terrorism charges, just days after a dramatic return to the city to face federal counts in the case.

Luigi Mangione, 26, was arraigned at a brief hearing with four New York police officers standing guard behind him. Minutes earlier, he was escorted to Judge Gregory Carro's 13th-floor courtroom bound by chain restraints, shackles and cuffs.

Mangione faces 11 state criminal charges, including one count of first-degree murder in furtherance of terrorism and two counts of second-degree murder, one as an act of terrorism. Mangione is accused of trying to "intimidate or coerce a civilian population." If convicted of the state charges, he could face life in prison without parole. A hearing on evidence to be used at trial was set for Feb. 21.

Mangione’s defense attorney, Karen Friedman Agnifilo, speaking in court, said the justice system is treating her client “like a human pingpong ball” by trying him in multiple jurisdictions and shuttling him between them in quick succession.

"They are treating him like he is some sort of political fodder, some sort of spectacle," Friedman Agnifilo said. "He is not a symbol, he is someone who is afforded a right to a fair trial."

The Ivy League graduate from a wealthy Maryland family has drawn support from some Americans upset by the high cost of health care and the refusal of insurers to pay for some medical treatments.

Dozens of demonstrators gathered outside the the Lower Manhattan courthouse Monday in support of Mangione. One protester played a trumpet and another shouted messages through a bullhorn as commuters walked past, navigating the crowd with temperatures in the teens. The growing crowd erupted into chants decrying a “for-profit” insurance landscape. Rallying cries included “health care now,“ "CEOs have got to go," and “health care is a human right, we shouldn’t have to fight."

'The target is insurance': Shooting suspect Luigi Mangione's notebook shows plan, feds say

Protesters speak out

Nicholas Zamudio, 33, wore thick, long gloves Monday and held a sign decrying the nation’s health care system, which he says stole his livelihood after he injured discs in his neck and back at work at a cellphone store in 2021. Zamudio said he and Mangione, who wrote about his own health care experiences and problems with his back, had the same surgery to treat similar injuries.

“My lumbar, it hurts right now, it keeps me from sleeping, it keeps me from enjoying life,” said Zamudio, who said he is no longer able to work because of his injury.

Another demonstrator, Alex Flanigan, said she is disgusted by how elected officials in New York responded to the case, which she said pits the nation’s top 1% against the masses who lack sufficient health care coverage.

“I want to add my voice to the call for a just health care system,” Flanigan said.

Flanigan, a medical student, also said law enforcement and Mayor Eric Adams unfairly turned Mangione into a spectacle. “He has received so much unjust treatment from law enforcement so far, such as the perp walk, and the amount of force that accompanied the suspect,” Flanigan said.

Federal conviction could bring death penalty

Federal charges unsealed Thursday mean Mangione could receive the death sentence if found guilty of murder in federal court. Those charges include murder using a firearm, two counts of stalking, and an additional firearms offense. A preliminary hearing on the federal charges was scheduled for Jan. 18.

Mangione also faces weapons and related charges in Pennsylvania, where he was arrested at a McDonald's restaurant after a five-day manhunt. Mangione appeared in a Blair County courtroom Thursday and drew a crowd of supporters there as well. Andrea Aye said she traveled from northern Ohio to the Pennsylvania courthouse for his hearing.

"We feel his anger, his frustration," said "It has definitely woke people up. We hear him."

At that hearing, Mangione waived his right to challenge extradition and was swept back to New York via plane, helicopter and SUV for his federal arraignment hours later. He arrived to dozens of heavily armed officers, a swarm of media and Mayor Eric Adams.

Defense lawyer calls charges 'very confusing'

In addition to the murder charges, Mangione's other state charges include two counts of criminal possession of a weapon in the second degree; four counts of criminal possession of a weapon in the third degree; one count of criminal possession of a weapon in the fourth degree; and one count of criminal possession of a forged instrument in the second degree.

Friedman Agnifilo said last week that the federal charges were an attempt to "pile on top of an already overcharged" state case against her client.

"Over three decades of prosecuting and defending criminal cases in New York, frankly, I've never seen anything like that what is happening here," Friedman Agnifilo said in federal court. She called the multiple prosecutions "very confusing, highly unusual."

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Federal charges: Suspect faces federal murder, stalking charges

Prosecutors look for motive in killing

Entries in a handwritten notebook seized from Mangione when he was arrested reflected his "hostility toward the health insurance industry and wealthy executives in particular," according to the federal criminal complaint. Mangione methodically planned the killing for months in an attempt to spark debate over insurance industry practices, federal prosecutors said in a statement.

Is CEO murder suspect a terrorist? Why charges may 'send a message.'

Brian Thompson remembered: 'A friend to all'

Thompson, 50, was raised on a farm between the small town of Jewell, Iowa, and the smaller town of Stanhope and graduated from South Hamilton High School in 1993. He departed for the University of Iowa and began working for UnitedHealthcare in 2004. He ascended through the ranks to head the Minneapolis-based health insurance company, one of the largest in the nation, and was named CEO in April 2021.

"He was one of the smartest kids, if not the smartest, and I would say the smartest person I've ever known," childhood friend Taylor Hill said. "He was probably smarter than half our teachers. And the thing with our teachers is they knew it, too."

Victim mourned: CEO Brian Thompson was a local farm boy

He had multiple leadership positions at UnitedHealthcare over the years. He last held the title of chief executive officer of government programs, including overseeing the company's Medicare, retirement, and community and state businesses.

"Brian was a highly respected colleague and friend to all who worked with him," UnitedHealth Group, the parent company of United Healthcare, said in a statement.

Contributing: Jeanine Santucci and Judy Ellich

This article originally appeared on USA TODAY: Luigi Mangione, charged with killing insurance CEO, pleads not guilty