Mangione alludes to back pain in explaining his actions

Surveillance video of the ambush showed a masked gunman shooting Thompson, 50, from behind. Police say “delay,” “deny” and “depose” were written on the ammunition, mimicking a phrase used to describe how insurers avoid paying claims.

That detail — and revelations that Mangione’s private writings lambasted health insurers as greedy, according to authorities — made the case a fulcrum for debate about the industry and made Mangione a cause célèbre for some of its critics.

A University of Pennsylvania graduate from a wealthy Maryland family, Mangione told the court Friday that he pursued Thompson “after years of enduring severe pain from a broken back and navigating the obstacles of the health insurance system.”

Friedman Agnifilo later said her client “believed that the system had failed him and destroyed his life.”

Authorities say Mangione’s grievances are no excuse for killing

Mangione never was a UnitedHealthcare customer, according to police and the company.

“To those who idolize Luigi Mangione, I say this. Violence is not a cause. Murder is not a message. And a killer is certainly not a hero,” New York Police Commissioner Jessica Tisch said outside court Friday.

U.S. Attorney Jamie McDonald, whose office handled the federal case, added: “There can be no celebrity in assassination.”

Thompson led one of the United States’ largest health insurers, but he wasn’t well known outside the industry. Trained as an accountant, he had worked at parent company UnitedHealth Group Inc. for 20 years and became CEO of its insurance arm, UnitedHealthcare, in 2021.

Thompson’s violent death “devastated everyone who knew and loved him,” the company said in a statement Friday, thanking law enforcement for bringing him to justice.

Now Mangione is pressing to end the state case

But his federal guilty plea does give him leverage to argue for closing out the New York state prosecution, which carries the potential for a separate long sentence.

The state’s double jeopardy protections can kick in if a prior prosecution ends in a guilty plea.

Mangione’s cases involve different charges arising from the same course of conduct. The Manhattan district attorney’s office, which is handling the state prosecution, said Friday that it remains committed to its case and would contest the defense’s efforts to shut it down.

In June, Mangione’s lawyers said they would pursue a psychiatric defense in the state case but reversed course a day later. The defense, involving claims that he was suffering from extreme emotional disturbance at the time of the killing, isn’t allowed in federal court.

In the federal case, Garnett had delivered some setbacks to the defense, including ruling in January that prosecutors could use items collected from Mangione’s backpack during his arrest as evidence against him. They included a 3D-printed pistol that investigators said matched the one used to kill Thompson and a notebook in which authorities say Mangione described his intent to kill an insurance executive.

Mangione was arrested five days after the shooting, when he was spotted at a McDonald’s in Altoona, Pennsylvania. It’s about 230 miles (370 kilometers) west of Manhattan. In the days after the shooting, police had released various images of the suspected shooter, including one showing his face as he checked into a hostel.

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Associated Press writers Dave Collins in Hartford, Connecticut, and Alanna Durkin Richer in Washington contributed.