Trial of a Symbol: Accused Health CEO Killer Pleads Not Guilty as Death Penalty Looms

Luigi Mangione, a 26-year-old accused of murdering UnitedHealthcare CEO Brian Thompson, has officially pleaded not guilty to multiple federal charges, including murder and stalking. The high-profile shooting occurred outside a Manhattan hotel in December last year. Mangione's plea means he will stand trial, and federal prosecutors have confirmed they will pursue the death penalty if he is convicted.

On Friday, Mangione appeared in a Lower Manhattan courtroom dressed in a prison uniform, his hands cuffed, and confirmed he had reviewed the indictment. When asked to respond, he simply stated, "not guilty." That same day, prosecutors submitted official notice of their intent to seek capital punishment, describing the killing as a politically motivated act targeting the healthcare industry.

Prosecutors argue that the murder was intended to send a broader message of ideological resistance against private health insurance. U.S. Attorney General Pam Bondi described Thompson's death as a case of political violence. Mangione's legal team, however, has condemned the possibility of execution as a “barbaric” response and has vowed to challenge it in court.

During a 35-minute pre-trial hearing, Judge Margaret Garnett began coordinating the legal schedule. Mangione’s defense team emphasized the magnitude of the evidence they must review—reportedly totaling over three terabytes—including surveillance videos, social media content, and communications from financial and telecom providers. As a result, his federal trial is unlikely to begin before 2026, with the next court appearance scheduled for 5 December.

Defense attorney Karen Friedman Agnifilo argued that the federal case should proceed before the state trial, citing potential constitutional issues if it doesn’t. She also accused state prosecutors of monitoring confidential jailhouse conversations between Mangione and his defense team. In response, the judge demanded a formal explanation from prosecutors and mandated the setup of a secure phone line for privileged attorney-client communication.

Judge Garnett requested Agnifilo file a revised motion to oppose the death penalty by 27 June, as her earlier motion predated the government’s formal notice. Additionally, the judge reminded prosecutors and federal officials, including Attorney General Bondi, of the need to avoid public commentary that could taint jury selection or jeopardize trial fairness.

In addition to the federal charges, Mangione faces state-level indictments in both New York and Pennsylvania, where he was captured five days after the killing. During his December arraignment in New York, he pleaded not guilty to state murder and terrorism-related charges. Authorities allege he fled the crime scene and crossed state lines before being apprehended at a McDonald’s in Pennsylvania.

Thompson’s murder has ignited public debate about the role of privatized healthcare in the U.S. While many condemn the act of violence, some have viewed Mangione as a symbolic figure challenging systemic injustice. Supporters have raised nearly $1 million for his legal defense, and demonstrators gathered outside the courthouse during his appearance. Investigators found shell casings at the scene engraved with the words “deny,” “defend,” and “depose”—terms critics say echo the tactics used by insurance firms to withhold care and maximize profit.