NEW YORK — The man accused of killing UnitedHealthcare’s CEO was whisked back to New York by plane and helicopter Thursday to face new federal charges of stalking and murder, which could bring the death penalty if he’s convicted.
Luigi Mangione was held without bail following a Manhattan federal court appearance that occurred shortly after he was returned to New York. He remained shackled at the ankles throughout the 15-minute proceeding, during which he told a magistrate he understands the allegations against him.
The hearing followed morning court appearances in Pennsylvania, where he was arrested last week five days after the shooting of Brian Thompson. Mangione now faces state and federal prosecutions in New York. Manhattan’s top federal prosecutor said in a release that the state charges were expected to proceed to trial first.
After his Pennsylvania court hearings, Mangione was immediately turned over to at least a dozen New York Police Department officers who were in the courtroom and led him to a plane bound for Long Island. He then was flown to a Manhattan heliport, where he was walked slowly up a pier by a throng of officers with assault rifles.
The federal complaint filed Thursday charges him with two counts of stalking and one count each of murder through use of a firearm and a firearms offense. Murder by firearm carries the possibility of the death penalty, though federal prosecutors will determine whether to pursue that path in coming months.
In a New York state indictment filed earlier this week, Mangione was charged with murder as an act of terrorism, which carries a possible sentence of life in prison without parole. New York does not have the death penalty.
His attorney said dual state and federal cases puts the defense in a highly unusual situation. “Frankly I’ve never seen anything like what is happening here,” said Karen Friedman Agnifilo. She reserved the right to petition for bail at a later point. Agnifilo declined to comment as she left the courthouse.
The 26-year-old Ivy League graduate is accused of ambushing and shooting Thompson on Dec. 4 outside a Manhattan hotel where the head of the United States’ largest medical insurance company was walking to an investor conference.
Authorities have said that when Magione was arrested on Dec. 9 while eating breakfast at a McDonald’s in Altoona, Pennsylvania, he had the gun used to kill Thompson, a passport, fake IDs and about $10,000.
According to the federal complaint, Magione also had a notebook that included several handwritten pages expressing hostility toward the health insurance industry and wealthy executives in particular.
An August entry said that “the target is insurance” because “it checks every box,” according to the filing. An entry in October “describes an intent to ‘wack’ the CEO of one of the insurance companies at its investor conference,” the document said.
Investigators believe Mangione was motivated by anger toward the U.S. health care system and corporate greed. But he was never a UnitedHealthcare client, according to the insurer.
Mangione initially fought attempts to extradite him. During two brief court appearances in Pennsylvania on Thursday, he waived a preliminary hearing on forgery and firearms charges before agreeing to be sent back to New York.
The killing ignited an outpouring of stories about resentment toward U.S. health insurance companies while also shaking corporate America after some social media users called the shooting payback.
Video showed a masked gunman shooting Thompson, 50, from behind and then firing several more shots. The suspect eluded police despite authorities widely circulating photos of his unmasked face until Mangione was captured in Altoona, about 277 miles (446 kilometers) west of New York.
Mangione, a computer science graduate from a prominent Maryland family, repeatedly posted on social media about how spinal surgery last year had eased his chronic back pain, encouraging people with similar conditions to speak up for themselves if told they just had to live with it.
In a Reddit post in late April, he advised someone with a back problem to seek additional opinions from surgeons and, if necessary, say the pain made it impossible to work.
“We live in a capitalist society,” Mangione 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.”
He apparently cut himself off from his family and close friends in recent months. His family reported him missing in San Francisco in November. His relatives have said in a statement that they were “shocked and devastated” by his arrest.
Thompson, who grew up on a farm in Iowa, was trained as an accountant. A married father of two high-schoolers, he had worked at the giant UnitedHealth Group for 20 years and became CEO of its insurance arm in 2021.
• Scolforo reported from Hollidaysburg, Pennsylvania. Associated Press writers Mike Rubinkam in Allentown, Pennsylvania; and John Seewer in Toledo, Ohio; contributed.
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