Brian Thompson, the 50-year-old CEO of the American health insurance company UnitedHealthcare, was shot and killed in MidtownManhattan, New York City, on December4, 2024. The shooting occurred early in the morning outside an entrance to the New York Hilton Midtown.[6] Thompson was in the city to attend an annual investors' meeting for UnitedHealth Group, the parent company of UnitedHealthcare. Prior to his death, he faced criticism for the company's rejection of insurance claims, and his family reported that he had received death threats in the past. The words "Delay", "Deny", and "Depose" were inscribed on the cartridge cases used during the shooting. The suspect, initially described as a white man wearing a mask, fled the scene.[1] On December9, 2024, authorities arrested 26-year-old Luigi Mangione in Altoona, Pennsylvania, and charged him with Thompson's killing in a Manhattan court.[7][8][9]
Authorities said Mangione was carrying a 3D-printed pistol and a 3D-printedsuppressor consistent with those used in the attack, as well as a short handwritten letter styled as a manifesto criticizing the American healthcare system, an American passport, and multiple fraudulent IDs, including one with the same name used to check into a hostel on the Upper West Side of Manhattan.[10][11][12] Authorities also said his fingerprints matched those that investigators found near the New York shooting scene.[13] Police believe that he was inspired by Ted Kaczynski's essay Industrial Society and Its Future (1995), and motivated by his personal views on health insurance.[14][15] They say an injury he suffered may have played a part,[16] although according to the company, he was not a customer of United Healthcare. Mangione was arraigned in Altoona, Pennsylvania, on December 9, 2024.[17] After waiving extradition in Pennsylvania, he appeared in a federal court in New York City on December 19.[18] Mangione has been indicted on eleven state charges and faces four federal charges; the charges include first-degree murder, murder in furtherance of terrorism, criminal possession of a weapon, and stalking. He is eligible for the death penalty.[19][20]
Thompson's death received widespread attention in the United States and led to polarized reactions.[21] Public officials expressed dismay and offered condolences to Thompson's family. Opinion polls found a majority of Americans held a negative view toward the killer and the killing, with younger respondents more likely to support them. On social media, reactions to the killing included contempt and mockery toward Thompson and UnitedHealth Group, sympathy and praise for Mangione, and criticism of the American healthcare system and health insurance industry – primarily regarding claim denial practices.[22] Inquiries about protective services and security for CEOs and corporate executives surged following the killing.[23]
Background
Thompson and UnitedHealthcare
Thompson was the chief executive officer (CEO) of UnitedHealthcare, the insurance arm of UnitedHealth Group, from April 2021 until his death.[24][25] His widow told NBC News that her husband received threats related to a "lack of [insurance] coverage".[26]
UnitedHealthcare insures 49 million Americans and generated $281 billion in revenue for the 2023 fiscal year.[27] In 2021, Thompson was criticized in an open letter from the American Hospital Association due to a UnitedHealthcare plan to start denying payment for what it deemed as non-critical visits to hospital emergency rooms.[28] UnitedHealthcare has been widely criticized for its handling of claims.[29] It and other insurers were named in an October 2024 report from the United States Senate Homeland Security Permanent Subcommittee on Investigations showing a surge in prior authorization denials for Medicare Advantage patients.[27] Under Thompson's leadership, UnitedHealthcare also began using artificial intelligence (AI) to automate claim denials, resulting in patients being unable to access medical care.[30]
The rate at which post-acute care claims were denied more than doubled between 2020 and 2022.[31] A class action suit filed against UnitedHealth Group in November 2023 alleged the company knowingly employed nH Predict, an AI model that had a 90% error rate.[32] In September 2024, a demonstration was held in Eden Prairie, Minnesota, outside the headquarters of UnitedHealth Group subsidiary and pharmacy services provider Optum, with protestors claiming Optum's business practices inflate medicine costs and force independent pharmacies out of business.[33]
Suspected assailant's preparations
The suspect arrived in New York City on November24, 2024, on a Greyhound bus. The bus route began in Atlanta, Georgia, but authorities do not know from which city or town he boarded.[34][29] He checked into the HI New York City Hostel on the Upper West Side of Manhattan on November24, 2024, with a falsifiedNew Jersey identification card and paid in cash.[35] He stayed all but one night of the 10 days he was in New York City at the hostel, checking out on December3, 2024.[29]
Killing and escape
CCTV video of Thompson's killing
Thompson was in New York City for an annual UnitedHealth Group investors' meeting, having arrived in the city on December 2, 2024.[36] On December 4, at around 6:45 a.m. EST (UTC−5), Thompson was walking along West 54th Street toward the New York Hilton Midtown hotel that was hosting the meeting.[37] The assailant, dressed in a light-brown or cream-colored hoodie waited across the street from the hotel for several minutes, then crossed over when he saw Thompson.[38][39] Standing approximately 20 feet (6 m) away from Thompson when he arrived at the entrance, the assailant fired three times at him from a suppressed 9 mm pistol,[40][38][39] striking him in the back and right calf.[37]
November 24 – Suspect checks into the HI New York City Hostel on the Upper West Side of Manhattan. His unmasked face was caught on CCTV during the check-in process. The suspect had two hostel roommates who said he would slip down his mask only when eating.[52]
6:17 a.m. – Suspect buys coffee, water, and granola bars at a Starbucks café (at 1380 6th Ave) two blocks away from the New York Hilton Midtown hotel, discarding the coffee cup and water bottle.[54][55][39]
6:30 a.m. – Surveillance footage captures the suspect walking while talking on the phone.[34]
6:39 a.m. – Suspect arrives in front of the New York Hilton Midtown hotel and waits for several minutes.[39][55]
6:40 a.m. – Thompson leaves the Marriott hotel (at 151 W 54th St) he stayed at the prior night, heading toward the New York Hilton Midtown hotel.[37]
6:44 a.m. – Thompson walks along the sidewalk toward the New York Hilton Midtown hotel and the assailant shoots him multiple times, racking his pistol after it appeared to jam; the suspect immediately flees northbound via a pedestrian walkway.[39][56]
6:46 a.m. – Police respond to a 911 call reporting that a person has been shot.[39]
6:48 a.m. – Officers arrive on scene and find Thompson with multiple gunshot wounds to his back and leg; he is taken to the hospital. Assailant is seen riding an electric bicycle north into Central Park.[39][54]
6:59 a.m. – A person appearing to be the suspect is seen riding a bike on West 85th St.[37]
7:04 a.m. – Suspect gets into a northbound taxi on 86th Street and Amsterdam Avenue.[49]
Three fired cartridge cases alongside three unfired cartridges were found at the scene.[54] The words "delay", "deny", and "depose" were written on the cases. "Depose" was inscribed on a casing from a round fired into Thompson, while "delay" was marked on an unfired cartridge ejected as the shooter appeared to be clearing a jam.[41][57] The three words are similar to the phrase "delay, deny, defend", a well-known phrase in the insurance industry alluding to insurance companies' efforts to not pay out claims.[58] Accordingly, police stated they are investigating whether the words suggest the killer's motive.[41]
A water bottle, candy wrapper, and phone were recovered from the scene and are believed to be connected to the shooter.[59] Police said they believed they found the shooter's backpack in Central Park on December 6, 2024.[60] The backpack contained a Tommy Hilfiger jacket and Monopoly money.[61]
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The New York City Police Department offered a reward up to $10,000 for information about the shooter on December 4, 2024.[62] The following day, authorities released images of a suspect taken by surveillance cameras at the hostel and a Starbucks café.[63] Two stills show the suspect's face including one with him smiling widely at a female desk attendant at the hostel.[64][59] Sources told CBS the front desk worker asked to "see his pretty smile."[15] The FBI joined the investigation and separately offered a reward of up to $50,000 for information leading to an arrest and conviction.[65]
The shooter was described by police as a white man, approximately 6 ft 1 in (185 cm) tall, wearing a light brown or cream-colored hooded jacket, dark pants, and black sneakers with white soles. He had a gray backpack and concealed his face with a black face mask.[38][48][66][67] Police said the suspect appeared to be proficient in the use of firearms[37] and was described as being "extremely camera savvy."[68]
Other developments
Shortly after the event, two of the houses owned by Thompson's family were swatted.[69] Stocks for UnitedHealth fell the week of the shooting and fell a further 5.6% on December 11, 2024.[70][71] In New York, following the killing, multiple CEOs were threatened, including through "wanted" posters in Manhattan.[72] Timothy Clancy, a researcher with START at the University of Maryland, suggested that copycat killings may arise from Brian Thompson’s murder.[73]
UnitedHealthcare, Blue Cross Blue Shield, and CVS Health, which operates Aetna, all removed photographs and other information about their executive leadership from their websites following Thompson's killing.[74][75] Managed care provider Centene canceled their in-person investor's day which had been scheduled for December 12, and instead planned a virtual conference.[76] Additionally, the days following Thompson's death saw a surge in inquiries about protective services and security for CEOs and corporate executives, according to private security firm Allied Universal.[77] Michael Sherman, the former chief medical officer at Point32Health, justified the concerns of health insurance executives, saying, "It doesn't seem paranoid to worry that someone who's had services denied that they may believe are important might be in an emotionally unstable state."[78]
His last known residence was in Honolulu, Hawaii.[87] In November 2024, Mangione was reported missing by his mother, who said the family had not heard from him since July of that year. It was around the same time during the summer of 2024 that Mangione stopped posting on social media.[88] Mangione's mother contacted the San Francisco Police Department, as she believed that Mangione lived in San Francisco and had a job in the area.[89]
Arrest and charges
The December 17, 2024, New York state charges indictment documentThe December 18, 2024, federal charges complaint document
Local police in Altoona, Pennsylvania, arrested Mangione on December 9, 2024, at a McDonald's restaurant in the city. An employee there called the police to say that a customer recognized the suspect from images released by the NYPD.[90][91] Altoona is about 280 miles (450 km) west of New York City.[82] In his bag they found a 3D-printed gun and a 3D-printed suppressor, which the police said are consistent with the weapon used in the shooting, and a falsified New Jersey driver's license with the same name as the one used by the alleged shooter to check into the Manhattan hostel.[10][92][5][93] The police also said that when they arrested Mangione, they found a three-page,[93] 262-word handwritten document about the American healthcare system, which they characterized as a manifesto.[94]
On December 13, Mangione hired Karen Friedman Agnifilo, former prosecutor at the Manhattan District Attorney's Office and former legal analyst with CNN, as his New York case defense attorney.[101] On December 17, New York prosecutors charged him with first-degree murder as murder committed in furtherance of terrorism.[102] This charge and indictment modifies with the murder charge that he was already charged with. The charge of murder as an act of terrorism holds more weight than just a simple murder charge. This is due to the fact that under New York Law this kind of charge can only be levied against an individual if they “intended to intimidate or coerce a civilian population, influence the policies of a unit of government by intimidation or coercion and affect the conduct of a unit of government by murder, assassination or kidnapping.”[103]
On December 19, Mangione was extradited to New York and transferred to the Metropolitan Detention Center in Brooklyn following his first appearance in the Manhattan federal court.[104][105][106] In addition to the eleven state charges, Mangione faces four new federal charges, including two counts of stalking, a new firearms-related offense, and murder through use of a modified firearm. He is now eligible for the death penalty.[107][108]
Prior to his arrest, Mangione had no prior criminal record.[109]
Manifesto
Journalist Ken Klippenstein published a 262-word handwritten note that he says was written by Mangione on December 10, 2024.[110] The document directly addresses federal law enforcement, states that the killing was a lone act and that methods involved "elementary social engineering, basic CAD, [and] a lot of patience". It references a spiral notebook containing notes and to-do lists, mentioned that "[the shooter's] tech was locked down" due to his engineering work, and apologizes for causing "strife or traumas" while insisting that "it had to be done".[12] According to The New York Times, the mention of CAD apparently relates to the process of 3D-printing the ghost gun's plastic frame.[111]
The note characterized healthcare executives as parasites who "had it coming" and criticized the U.S. healthcare system, noting that, despite it being the most expensive in the world, America ranked roughly 42nd in life expectancy. It specifically mentioned UnitedHealth's market capitalization, describing it as one of the largest U.S. companies, behind only Apple, Google, and Walmart. The note argues that, while many individuals had illuminated the corruption and greed within the American healthcare system decades ago, the problems have continued to persist. It goes on to say that it was "not an issue of awareness at this point, but clearly power games at play," and concludes by describing the shooter as "the first to face it with such brutal honesty".[12]
Possible motives
The current investigator theory of motive is ill will towards the health insurance industry.[112] Police believe the motive was partially related to an injury that Mangione had suffered that caused him to visit the emergency room in July 2023. Online photos posted by Mangione showed screws in his back.[16][112] Mangione had spondylolisthesis, a lower back condition.[113] Sources told CBS they believed Mangione had resentment towards UnitedHealthcare as well as other health insurance companies.[15] According to UnitedHealthcare, he was not one of their customers.[114] New York Police Chief of Detectives Joseph Kenny believes Mangione may have targeted them because of the company's size.[114]
Police believe that Mangione was inspired, in part, by Ted Kaczynski's Industrial Society and Its Future.[14] Mangione's account posted a Goodreads review of Industrial Society and Its Future,[115] describing Kaczynski as "rightfully imprisoned" and was critical of his use of violence against innocent individuals. The review, which gave the manifesto four out of five stars, also contained a quote that the reviewer claimed to have found online. The quote contained the lines "'Violence never solved anything' is a statement uttered by cowards and predators" and "when all other forms of communication fail, violence is necessary to survive."[116][117][118]
Reactions
Public and online
Many social media users expressed their contempt for Thompson, UnitedHealthcare, and the nation's health insurance system while expressing sympathy for and praising the assailant for his actions.[119][120][121][122] Social media users shared personal stories of harm and death suffered resulting from claim denials,[123][124] and joked about the killing with memes and gallows humor.[78] A popular comment on the r/nursing subreddit mocked Thompson's death by emulating a denial of coverage letter for Thompson's emergency care.[123] One physician told The Daily Beast that they believed the perpetrator should be brought to justice, but they also stated that Thompson's role as CEO had led to a great amount of suffering and loss of life, which he described as "on the order of millions", adding that "[it is] hard for me to sympathize when so many people have suffered because of his company".[125] Internet culture journalist Taylor Lorenz analyzed the responses on social media and wrote on her blog: "No, that does not mean people should murder them. But if you’ve watched a loved one suffer and die from insurance denial, it’s normal to wish the people responsible would suffer the same fate."[126]
"Deny Defend Depose" graffiti in New York City
The shooter has been called a folk hero and celebrated as a vigilante by some of the general public. He has been compared to Robin Hood[127] and the Dillinger Gang.[128] Internet users nicknamed the perpetrator "the Adjuster", "the Claims Adjuster", and "Robin Hoodie".[7][129][130] Mangione has also been noted for his perceived physical attractiveness.[131][132] The McDonald's where Mangione was arrested was review bombed as a result of a tip from a customer who alerted an employee after recognizing the suspect.[133][134][135][136] A viral tweet by a software engineer who provided information on how to find the assassin after examining data from Citi Bike's bikeshare program was called a "snitch" by some Twitter users.[137]
After Thompson's death, UnitedHealthcare's parent company, UnitedHealth Group, published a statement on Facebook detailing the death and their official condolences. Though the post's comment section was deactivated, over 100,000 Facebook users responded to the post with a "Haha" (or "laughing") reaction.[138][123][139] Items and merchandise in support of Mangione were posted on Etsy, Amazon and other e-commerce sites before being removed.[140][141][142] According to the Network Contagion Research Institute, since Mangione's arrest, variations of "#FreeLuigi" have been shared over 50,000 times on X. They also found that "by some measures", engagement with posts about Thompson's killing on platforms such as X and Reddit "surpassed that of the assassination attempt against Donald Trump in July."[143]
Crowdsourcing fundraisers were also started by supporters of Mangione to cover his legal costs on GoFundMe, before being removed.[144] A GiveSendGo fundraiser has remained live;[145] as of December 18, it has raised nearly $151,000.[146] Other social media users linked Mangione's jail commissary account soliciting donations for "snacks, sodas, an iPad, etc."[147] Thomas Dickey, Mangione's defense attorney, commented on the crowdfunding campaign by saying: "The Supreme Court says all these rich billionaires can give all kind of money to candidates and that's 'free speech,' so maybe these people were exercising their right to free speech and saying that's the way they're supporting my client."[148]
The BBC reported that the lack of pity for Thompson expressed online "seemed to bridge the political divide".[149] Prominent conservative commentators, like Ben Shapiro and Matt Walsh, received online backlash from their viewership for condemning the criticism of Thompson and for portraying it as an exclusively leftist sentiment.[129][150] The Network Contagion Research Institute found that out of the top ten most-engaged tweets that mention Thompson or UnitedHealth, six of the posts implicitly or explicitly supported the killing or criticized Thompson. Some highlighted comments called for further assassinations of CEOs and class war;[151] a researcher at the institute said that the incident was framed as "some opening blow in a class war" and that praise for the killing came from across the political spectrum.[123]
Health insurance corporations
UnitedHealth Group CEO Andrew Witty defended the company's claim denial practices in an internal video which was leaked after the fatal shooting of Thompson. Recorded on December 5, the day after Thompson's death, Witty emphasized the company's role in ensuring "safe and appropriate" care and that the insurance giant will continue to prevent "unnecessary care".[152] Some online comments made death threats in response,[153] with Fortune pointing out that UnitedHealthcare's was twice the industry average for denied claims and that "their policies contributes to medical bankruptcies and lives lost due to denied care, highlighting widespread anger at systemic issues in U.S. health care".[154]
One former health insurance executive was quoted by the Financial Times as saying that threats against health insurance companies are common, and that "We'd have times when you'd deny proton laser therapy for a kid with seizures and the parent would freak out." Another executive was quoted as saying, "What's most disturbing is the ability of people to hide behind their keyboards and lose their humanity."[155][123]
Politicians
In response to the killing, public officials including Minnesota governor Tim Walz and Senator Amy Klobuchar expressed dismay and offered condolences to the family. Walz said that he knew Thompson.[156] Democratic House representative Dean Phillips wrote that he was "horrified" by the assassination.[157] Pennsylvania Governor Josh Shapiro commented that "Some attention in this case, especially online, has been deeply disturbing, as some have looked to celebrate instead of condemning this killer."[158] Maryland state delegate Nino Mangione, cousin of Luigi Mangione said, "Our family is shocked and devastated by Luigi's arrest. We offer our prayers to the family of Brian Thompson, and we ask people to pray for all involved".[159]
Commenting on Thompson's killing in an interview on ABC'sThis Week, Democratic House representative Ro Khanna said, "There is no justification for violence". He added that the public reaction to Thompson's killing did not surprise him because "We waste hundreds of billions a year on health care administrative expenses that make insurance CEOs and wealthy stockholders incredibly rich while 85 million Americans go uninsured or underinsured".[160] Democratic Senator Elizabeth Warren said: "The visceral response from people across this country who feel cheated, ripped off, and threatened by the vile practices of their insurance companies should be a warning to everyone in the health care system. Violence is never the answer, but people can be pushed only so far."[161] Democratic Representative Alexandria Ocasio-Cortez said: "This is not to say that an act of violence is justified, but I think for anyone who is confused or shocked or appalled, they need to understand that people interpret and feel and experience denied claims as an act of violence against them."[162]
Academic commentators
Zeynep Tufekci, a professor of sociology and public affairs at Princeton University and New York Times columnist, said that the public reaction to the fatal shooting of Thompson resembled the reaction to the very high levels of corporate greed, exploitation, and economic inequality during the American Gilded Age, a period characterized by violent "political movements that targeted corporate titans, politicians, judges and others".[163] Tufekci further wrote: "The concentration of extreme wealth in the United States has recently surpassed that of the Gilded Age. And the will among politicians to push for broad public solutions appears to have all but vanished. I fear that instead of an era of reform, the response to this act of violence and to the widespread rage it has ushered into view will be limited to another round of retreat by the wealthiest."[163]
An Emerson College poll surveyed 1,000 American registered voters between December 11 and 13 and found that a majority (68%) of voters view the actions of the suspected killer as unacceptable. Among young voters aged 18-29, 41% found the killing "acceptable or somewhat acceptable", while 40% in the same age group did not, making it the only age group where those who found the actions acceptable outnumbered those who did not.[164][165]
A December 12, 2024, online poll of 1,000 registered voters in the US taken by pollster Scott Rasmussen/RMG Research, Inc. found that 53% of respondents view the killer as a "villain", while 10% view the killer as a "hero", 22% said neither label applies and 15% said they were unsure. 71% of voters said murder is "never justifiable." The poll found that younger voters, Progressive Democrats, "people who talk politics every day", and those with a postgraduate degree were "more likely than others to say that such murder is sometimes justifiable".[166]
An Economist/YouGov poll conducted from December 15 to 17 surveying 1,553 U.S. adult citizens found that 43% of American citizens had a "somewhat unfavorable or very unfavorable" view of Mangione, while 21% had a "somewhat favorable or very favorable view of him." 37% were unsure. Mangione received the most support from citizens aged 18-29, who viewed him favorably by a 39%–29% margin, and very liberal citizens, who viewed him favorably by a 47%–31% margin. Mangione was viewed least favorably by citizens aged 65 and older (65%–5% unfavorable) and very conservative citizens (62%-8% unfavorable).[167]
Other
Independent journalist Ken Klippenstein stated that numerous major media outlets refused to publish Mangione's alleged manifesto despite being in possession of it, writing "My queries to The New York Times, CNN and ABC to explain their rationale for withholding the manifesto, while gladly quoting from it selectively, have not been answered." Klippenstein also alleged that The New York Times directed their staff to "dial back" on showing photographs containing Mangione's face.[168][169]Engadget reported that moderators of subreddits on Reddit were instructed to remove posts and links containing Mangione's alleged manifesto. A Reddit spokesperson said that posting the alleged manifesto violated the company's rules, which prohibit content that "encourages, glorifies, incites, or calls for violence or physical harm".[170]
David Kaczynski, the surviving brother of the "Unabomber" Ted Kaczynski, expressed concern over his late brother's apparent influence on Mangione, stating: "It really gives me a great deal of personal pain to think my brother's actions have in any way contributed to influencing a man like this to kill an innocent human being."[171]
A week after the shooting, a woman in Florida was arrested and charged after allegedly saying "Delay, deny, depose, you people are next" to representatives of Blue Cross Blue Shield after her claim was denied.[172][173][174] The judge set her bail at $100,000, citing "the status of our country at this point".[175]
On December 17, an employee at Anderson Express, a manufacturing company in Muskegon, Michigan, was arrested and charged with attempted murder after allegedly stabbing the company's president during a work event. The Fruitport Township Police Chief stated they were investigating the possibility that the stabbing was a copycat attack.[176]
^ abcGibbons-Neff, Thomas; Toler, Aric (December 12, 2024). "When a Glock Isn't a Glock: The History of the Pistol Found With Luigi Mangione". The New York Times. Retrieved December 12, 2024. At first glance, the gun in the police photographs — the one the authorities believe Luigi Mangione used to kill the chief executive of UnitedHealthcare — appears to be a Glock-19, a 9-millimeter semiautomatic pistol ...But upon closer inspection, it is clear that the weapon was not factory-made, but was at least partially produced by a 3D printer. ...
"D.A. Bragg Announces Murder Indictment Of Luigi Mangione". Manhattan District Attorney's Office (Press release). December 17, 2024. Retrieved December 19, 2024. Two of the discharged shell casings had the words "DENY" and "DEPOSE" written on them, and the word "DELAY" was written on a bullet, all found at the scene.
^Newman, Andy (December 5, 2024). "Suspect in Killing of Insurance C.E.O. Is Said to Have Used Fake New Jersey ID". The New York Times. Archived from the original on December 8, 2024. Retrieved December 6, 2024. One of investigators' main goals remains finding a surveillance image of the suspected shooter where his face is entirely unobscured, a senior law enforcement official said, describing the man as extremely camera savvy. Even in the pictures released earlier today, the man the police are seeking is wearing a hood.
