Luigi Mangione will assert psychiatric defense in murder case in UnitedHealthcare CEO’s killing

NEW YORK (AP) — Luigi Mangione plans to assert a psychiatric defense at his state murder trial, claiming he was suffering from extreme emotional disturbance when he gunned down UnitedHealthcare CEO Brian Thompson, a judge said Wednesday. That could mean less prison time if he’s convicted.

A jury that accepts such a defense would be obligated to convict Mangione of manslaughter, which carries a maximum sentence of 25 years in prison, instead of murder, which could put him behind bars for the rest of his life. An emotional disturbance defense isn’t available in Mangione’s federal case, where he also faces a possible life sentence.

New York Judge Gregory Carro announced the defense’s decision in court two weeks after holding a secret hearing on the matter. He said he will unseal a transcript and other records from that hearing once redactions are made.

Carro said Mangione’s lawyers first raised the possibility of a psychiatric defense last year in a letter that was filed under seal and confirmed their decision at the June 3 hearing, which the judge said was held in secret at the defense’s request.

“The reasons for the sealing was to give the defense an opportunity to determine whether they were going forth with that defense and the nature of that defense,” Carro said.

Carro said he didn’t expect the development to delay Mangione’s trial, which is scheduled to begin with jury selection on Sept. 8. His next pretrial hearing is scheduled for Aug. 11.

Assistant District Attorney Joel Seidemann said he wants Mangione evaluated by a prosecution psychiatrist. To facilitate that, Carro said, Mangione could soon be moved to New York City’s Rikers Island jail complex from a federal jail in Brooklyn, where he has been held since shortly after his December 2024 arrest.

Mangione, 28, has pleaded not guilty to state and federal charges in the Dec. 4, 2024, killing. His federal trial, which involves stalking charges, is set to begin on Oct. 13.

Mangione, sitting between his lawyers and wearing a blue suit, didn’t appear to react as Carro spoke. At a February at a hearing, Mangione railed against the prospect of two trials, telling Carro: “It’s the same trial twice. One plus one is two. Double jeopardy by any commonsense definition.”

An extreme emotional disturbance defense wouldn’t absolve Mangione of responsibility for Thompson’s killing. It is not the same as a not guilty by reason of insanity defense, which would allow a defendant to go to a psychiatric facility instead of prison.

Mangione’s lawyer, Karen Friedman Agnifilo, said unsealing the transcript of the secret hearing and materials related to his psychiatric defense will harm him in his federal case.

“The reason why we asked for the sealing is that this defense is not available federally and Mr. Mangione is being prosecuted federally and this is prejudicial to his defense to the exact same facts,” Friedman Agnifilo said.

The judge had been set to rule on the matter Tuesday, but was forced to delay it a day because prosecutors failed to let Mangione’s jail know that he was needed in court.

Thompson, 50, was killed as he walked to a Manhattan hotel for UnitedHealth Group’s annual investor conference. Surveillance video showed a masked gunman shooting him from behind. Police say “delay,” “deny” and “depose” were written on the ammunition, mimicking a phrase used to describe how insurers avoid paying claims.

Mangione, an Ivy League graduate from a wealthy Maryland family, was arrested five days later at a McDonald’s in Altoona, Pennsylvania, about 230 miles (about 370 kilometers) west of Manhattan.

At a May 18 hearing, Carro ruled that a gun and notebook that prosecutors say link Mangione to the killing can be used as evidence against him. The gun, a 3D-printed pistol, matches the one used to kill Thompson, prosecutors said. The notebook describes wanting to “wack” a health insurance executive and rebelling against “the deadly, greed fueled health insurance cartel.”

On Wednesday, Carro dismissed a charge related to a gun magazine that he had ruled inadmissible because it was found during an initial search of Mangione’s backpack at the McDonald’s.

To establish an emotional disturbance defense, Mangione’s lawyers must show that the disturbance was so extreme it robbed him of self-control; that, in his mind, he had a reasonable explanation or excuse for the disturbance; and that he killed Thompson while “under the influence” of that disturbance.

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This story has been corrected to show that Mangione could receive less prison time as a result of a conviction using this defense, not be sent to a psychiatric facility.