What we know about the investigation so far
- Luigi Mangione, 26, is charged with murder in the death of UnitedHealthcare CEO Brian Thompson, who was shot and killed in New York last Wednesday. He was arrested Monday after he was spotted at a McDonald's in Altoona, Pennsylvania.
- Mangione is in jail in Pennsylvania, where he was denied bail, and is resisting extradition to New York to face trial — a process that could take weeks.
- The gun recovered from Mangione in Pennsylvania matched three shell casings found at the scene of the homicide, New York police said. The suspect's fingerprints also matched those found on a water bottle and a snack bar police in New York found.
- Mangione had a notebook in which he is alleged to have written about targeting a CEO, two sources familiar with the investigation said. In archived social media posts, he wrote of the "devastating" and "brutal" effects of living with a painful chronic back condition that required surgery.
- Mangione shouted to cameras as he arrived for his extradition hearing yesterday: "It’s completely out of touch and an insult to the intelligence of the American people."
Roughly 6 in 10 adults experience problems when they use their insurance
In a series of archived posts from a now-deleted Reddit account, Mangione wrote extensively about a chronic back condition that he said caused him immense pain.
New York police are looking into whether a denied insurance claim related to the injury played a role in the shooting, Chief of Detectives Joseph Kenny told Fox News on Tuesday.
Health insurers' refusing to pay for cancer care, surgical procedures or other lifesaving treatment is a common frustration for many people in the U.S. and a potentially devastating problem for some, experts say.
Roughly 6 in 10 insured adults experience problems when they use their insurance, including insurers' refusing to pay for care, according to a 2023 survey published by KFF, a nonprofit group that researches health policy issues.
Refusals to pay for care are more common for people with employer-based health insurance or private insurance compared with people with public insurance, such as Medicare and Medicaid. About 1 in 5 insured adults who use emergency services had denied claims.
NYPD intel chief says effect of CEO's slaying resembles domestic terrorism
The impact of Thompson’s slaying resembles a domestic terrorist attack and threatens to set off a “contagion,” Rebecca Weiner, the NYPD’s deputy commissioner for intelligence and counterterrorism, said at an Atlantic Council event in Washington today.
“I think regardless of what the courts determine the motivation to be, the impact is similar to that of a domestic terror attack, and that is already being reflected in this torrent of online vitriol that we’ve been in the midst of since last Wednesday and the lionization of the alleged perpetrator of the murder as a hero,” Weiner said.
“When we are concerned about terrorism, it is in part because of the outsized impact of a particular act of violence. This one has all the hallmarks of something that is going to inspire and contribute to the contagion effect,” she said.
What to expect next from Mangione's extradition fight
Mangione is entitled under the Extradition Act to challenge his detention by filing a petition for habeas corpus. The judge gave his defense team two weeks to do so.
He will lose. But he is entitled to challenge his detention. (Once he loses, he is entitled to appeal. However, if he’s transferred before the appeal is completed, then it’s moot.)
Mangione can’t be extradited before that petition is filed, even if his lawyers wait the full two weeks to do so. The legality of extradition — a constitutionally mandated process — must be challenged in the asylum state (Pennsylvania in this case) before he is transferred to the demanding state (New York).
None of the New York evidence matters in the extradition hearings; the hearings aren’t probable cause determinations. A Pennsylvania court is merely obligated to make sure that the four key requirements of the Extradition Act have been satisfied: (1) Is Mangione the suspect New York wants? (2) Has New York charged him? (3) Is its paperwork in order? and (4) Was Mangione in New York at the time of the homicide?
Mangione could conceivably contest that he was in New York, but the rules of evidence are relaxed, so the court might just call an officer who says he or she has reviewed evidence showing that the suspect was in New York at the time of Thompson’s murder.
NYPD: Gun seized in Pennsylvania matches shell casings at Manhattan crime scene
The NYPD said a gun seized in Pennsylvania from Mangione matched three shell casings found where Thompson was shot and killed in Manhattan.
Furthermore, NYPD Commissioner Jessica Tisch said at an unrelated news conference today, Mangione’s fingerprints taken in Pennsylvania matched those found on a water bottle and a Kind snack bar that police found at the New York crime scene.
Police officials had said the suspected gunman visited a Starbucks before the shooting, purchasing a water bottle and two protein bars. The suspect is alleged to have discarded those items, which police collected as evidence.
Mangione's notebook said to 'wack the CEO' at 'parasitic bean-counter convention,' sources say
Two sources familiar with the investigation said the notebook found on Mangione included writings, such as: “What do you do? You wack the CEO at the annual parasitic bean-counter convention. It’s targeted, precise, and doesn’t risk innocents.”
Mangione had a notebook in which he allegedly wrote about plans to target a CEO at a conference
Mangione was found carrying a notebook, in addition to a previously reported three-page handwritten letter, two sources familiar with the investigation told NBC News.
In that notebook, he is alleged to have written about wanting to target a CEO at a conference with a gun and expressed that such a method was preferable to other means — like a bomb or some other explosive device — so others wouldn’t be harmed.
Former FBI assistant director says Mangione may be a 'cause killer'
Frank Figliuzzi, a former FBI assistant director for counterintelligence and an NBC News national security analyst, said it’s increasingly looking like Mangione is “a cause killer.”
Mangione was found with handwritten notes in which he said “these parasites had it coming” and expressed criticism of the U.S. health care industry and large corporations, sources said. Yesterday, as he arrived at court, he shouted toward reporters: “It’s completely out of touch and an insult to the intelligence of the American people and their lived experience!”
“He’s driven by ideology and not necessarily a direct, personal beef with his targeted victim,” Figliuzzi said today on MSNBC’s “Ana Cabrera Reports.” He suggested that may make it harder for detectives investigating a motive, noting it’s possible Mangione wasn’t even insured by UnitedHealthcare.
“Don’t expect a direct line. We haven’t found that yet. Moreover, he simply did research — it’s quite possible he found that United was the most egregious offender in his mind, so that makes it hard,” he added.
Mangione’s fingerprints match those found near the NYC crime scene, source says
Fingerprints taken from Mangione match some prints found near the New York City crime scene, a senior law enforcement official told NBC News.
It’s not clear where the New York prints were taken from. Police have said the suspected gunman had visited a Starbucks before the shooting and bought a water bottle and two protein bars. Deputies recovered a video showing where those items were discarded, and both were collected as evidence.
Police say it's unclear if Mangione's family or friends recognized his wanted photos and reported him
NYPD officials were pressed this morning on MSNBC’s “Morning Joe” about whether any of Mangione’s relatives or friends recognized him in photos released by police and contacted authorities when he was on the run.
“Post-arrest investigation here, I think all these things will be asked and answered in time,” NYPD Chief of Patrol John Chell said. “When the picture went out, the thought process from everyone was, like, if someone knows this person, you say, ‘Hey, that’s John.’ That’ll all come out.”
Deputy Commissioner of Operations Kaz Daughtry said: “I think we had over 400 tips that came in. We’re still vetting each one of those tips. But thank God for the customer that was in the McDonald’s.”
Suspect ‘loved Japanese culture’ but critiqued its society
Mangione made multiple visits to Japan this year, according to those who spoke with him.
During one of his visits Feb. 25, Mangione entered a restaurant in Tokyo, where he sat at the counter, said Obara Jun, a Japanese poker player who saw Mangione struggle with ordering in the restaurant.
“He was very friendly, and it didn’t take long for us to get to know each other,” Jun said by text message today.
'I can’t imagine what drove him to this,' former teacher says
Gilman School teacher Liz Sesler-Beckman, who taught Mangione for two years in middle school, expressed shock over his arrest this week.
“It’s like a cognitive dissonance between the person that we all knew and the person who would commit such a heinous crime. It just doesn’t make any sense, and it certainly goes against the values of the school that we all were part of the community,” Sesler-Beckman told NBC affiliate WICU of Erie, Pennsylvania.
“He was very involved in athletics; he was in a lot of clubs. Being the valedictorian in a school like that, it’s a very difficult task, because there are so many superior students. I just remember him as always being a kind, well-liked person. I just can’t imagine what drove him to this,” she added.
She said that while there are some students teachers worry about, Mangione was never one of them for her.
“I am devastated for the Gilman community, his family and of course for the victim’s family. It’s just unthinkable that he would resort to that kind of violence,” she said.
Friends of suspect in shock over murder charge
People who know Mangione have expressed shocked over his murder charge this week.
RJ Martin told NBC News he met Mangione in Hawaii, where, authorities say, he recently lived. He said Mangione wanted to surf but struggled because of back pain and at times found it hard to sit up straight.
"I knew it was something that constantly weighed on him; it was something that impeded him from doing many things," he said. "It just broke my heart to know he had these 3-inch screws in his spine."
Martin added: "He was such a bright person. He had everything going for him. He was the kind of person you know was going to do great things."
Liz Sesler-Beckman, Mangione's former middle school teacher, told NBC News that she was shocked.
"I just remember him as always being a kind, well-liked person. I just can't imagine what drove him to this," she said.
What happens next? Shooting suspect intends to plead not guilty as he resists extradition
Luigi Mangione was charged with murder Monday night in New York in the death of UnitedHealthcare CEO Brian Thompson, as well as separate charges including forgery and possession of a weapon in Pennsylvania.
He was denied bail in Pennsylvania yesterday and did not waive extradition, meaning he’s contesting extradition to New York.
New York Gov. Kathy Hochul said yesterday she will issue a governor’s warrant for Mangione’s extradition. A Pennsylvania judge gave prosecutors 30 days to obtain that warrant to ensure Mangione “is tried and held accountable.”
His attorney, Thomas Dickey, said Mangione will plead not guilty to the charges in Pennsylvania and is expected do the same in New York.
Shooting suspect complained of 'devastating' effect of chronic back problem
Luigi Mangione, the suspect in the killing of UnitedHealthcare CEO Brian Thompson, wrote online of the “devastating” effect a chronic back condition had on him as a young man.
In a series of archived posts from a now-deleted Reddit account with the username Mister_Cactus, the 26-year-old wrote posts spanning several years that he suffered from “spondy,” a reference to spondylolisthesis, a condition caused by a vertebra slipping out of place and putting pressure on the bones below.
In one post he said: "It is absolutely brutal to have such a life-halting issue."
He said that he aggravated the condition in a surfing accident that caused his back and hips to “lock up.”
In a 2023 post on the subreddit, or chatroom, dedicated to spondylolisthesis Mangione wrote: “When my spondy went bad on me last year … it was completely devastating as a young athletic person. Seemingly all I could read on the internet was that I was destined to chronic pain and a desk job for the rest of my life.”
He went on to say however that “that representation was terrifying, inaccurate and completely destroyed me until I realized the silent majority of fusions are highly successful.”
Spinal fusion surgery is where vertebrae are joined with metal plates, screws or rods to prevent the painful effects of them moving against each other, according to the Mayo Clinic.
Investigators said Monday they were looking into whether an X-ray image uploaded to Mangione's X account, showing metal screws inserted, was genuine.
Mangione wrote in February this year of having spinal surgery six months earlier after “failed conservative treatment.”
Elsewhere, he suffered from sciatica and lower back pain as well as numbness in his right toe. He said his toe “used to go completely numb anytime I walked,” though he went on to say this symptom had improved. He posted about suffering from restless sleep as well as “bladder and genital pain.”
In other posts from the now-deleted account, Mangione shared detailed tips on what kind of backpack and other gear to go traveling with, as well as fantasy football and the mobile game Pokemon Go.
But also he offered advice to other spondylolisthesis sufferers on how to persuade surgeons and health care providers to carry out operations in the face of rejections.
“Keep trying different surgeons,” he wrote in response to one person who had apparently complained of being refused surgery in April this year. “‘No one will operate on my back until I’m 40’ is nonsense coming from a medical professional who lacks perspective. If you back is broken and it’s unlivable, age has nothing to do with it.”
Mangione suggests as a “nuclear option” the person could “fake a foot drop or piss yourself.”
He offers support and advice to several others who have apparently been refused surgery.
Catch up with NBC News' coverage of the killing of Brian Thompson
- CEO shooting suspect ‘loved Japanese culture,’ but critiqued its society
- Suspect in CEO’s shooting expected to plead not guilty, lawyer says
- Timeline: UnitedHealthcare CEO shooting suspect Luigi Mangione’s movements before and after arrest
- Brother of 'Unabomber' Ted Kaczynski: It's a 'terrible mistake' if Luigi Mangione was influenced by him