Luigi Mangione plans to mount a psychiatric defense in his state murder trial for the killing of UnitedHealthcare CEO Brian Thompson, claiming he was suffering from extreme emotional disturbance at the time of the shooting, a judge ruled Wednesday.
The defense strategy could result in a lesser conviction—manslaughter rather than murder—if accepted by a jury. Manslaughter carries a maximum sentence of 25 years in prison, compared to life imprisonment for murder. This defense is not available in the federal case already brought against Mangione.
New York Judge Gregory Carro announced the decision two weeks after holding a closed-door hearing on the matter. He stated that the sealed hearing was necessary for the defense to determine whether and how to pursue the psychiatric defense, particularly given the overlapping federal charges.
Carro confirmed that Mangione’s attorneys initially raised the psychiatric defense option in a sealed letter last year and formally affirmed their decision during the June 3 hearing. The judge does not expect the development to delay the trial, which is scheduled to begin with jury selection on September 8.
Authorities say Thompson was shot in the back while walking to a Manhattan hotel for UnitedHealth Group’s annual investor conference on December 4, 2024. Surveillance footage showed a masked gunman firing the shots. The words “delay,” “deny,” and “depose” were found etched on the ammunition, echoing common insurer tactics for avoiding payouts.
Mangione, a 28-year-old Harvard-educated man from a wealthy Maryland family, was arrested five days later at a McDonald’s in Pennsylvania. Prosecutors have linked him to the crime through a 3D-printed gun and a notebook containing references to targeting health insurance executives and opposing “the deadly, greed-fueled health insurance cartel.”
At a recent hearing, Carro ruled that the gun and notebook are admissible as evidence. However, he dismissed a charge related to a gun magazine found in Mangione’s backpack during the initial arrest.
Mangione has pleaded not guilty to both state and federal charges. His federal trial, which includes stalking charges, is scheduled for October 13. His lawyer, Karen Friedman Agnifilo, argued that revealing details of the psychiatric defense would prejudice the federal case, which does not permit such a defense.
The trial date remains unchanged despite objections from Mangione, who previously called the prospect of separate trials “double jeopardy by any commonsense definition.”