Luigi Mangione, Penn grad charged in slaying of UnitedHealthcare CEO, is fighting extradition to New York

Luigi Mangione, the University of Pennsylvania graduate accused in the slaying of UnitedHealthcare CEO Brian Thompson, shouted at TV news cameras and struggled with deputies Tuesday outside a courthouse in Blair County, Pa., moments before telling a judge he intended to fight his extradition to face murder charges in New York.

“That’s completely out of touch and an insult to the American people,” the 26-year-old suspected shooter yelled at awaiting reporters as he emerged from a patrol car moments before the court hearing. Deputies quickly grabbed him by the shoulder and pushed him inside the building.

While exactly what the 26-year-old suspected shooter was referring to remained unclear, Mangione’s statements were his first public remarks since his arrest Monday at a McDonald’s restaurant in Altoona and since his background and his whereabouts in the days since Thompson’s slaying captured the nation’s attention.

» READ MORE: United Healthcare shooting suspect screams at press as he's taken into court

Investigators continued working Tuesday to flesh out Mangione’s movements and motivations — especially in the last week, during which they believe he spent at least part of his time hiding in Pennsylvania.

But as they continued to sketch out a profile of their suspect, what they uncovered seemed only to prompt more questions.

For instance, few immediate clues appeared to explain what prompted Mangione, who was raised in privilege as a part of a prominent Baltimore-area family, to carry out the targeted slaying of Thompson in what seems to have been an ideologically motivated attack in response to what he called the “parasitic” behavior of large health insurers.

Even more puzzling, in the six months before the shooting, Mangione cut off communication with friends and family — prompting his mother to file a missing-person report last month — and leaving detectives to wonder what he was up to in the time between.

During Tuesday’s extradition proceeding in Hollidaysburg, Pa., defense attorney Thomas Dickey told the judge that Mangione intended to fight his return to New York, setting off a legal process that Blair County District Attorney Peter J. Weeks said could take up to 45 days to complete.

It “creates more hoops for law enforcement to jump through,” Weeks told reporters afterward. Mangione is now entitled to an evidentiary hearing, where investigators may have to call witnesses, and New York Gov. Kathy Hochul must submit what is known as a “governor’s warrant” to Pennsylvania Gov. Josh Shapiro before the extradition process can proceed.

In the meantime, Mangione will remain in the custody of the Pennsylvania Department of Corrections, where he has been held since his arrest on weapons charges and other related offenses.

Dickey also pressed the court Tuesday to reconsider the decision to hold Mangione without bail — a request Blair County Court Judge David Consiglio denied. At one point, Mangione, seated at the defense table, began to speak in response to the back-and-forth, but was quickly quieted by Dickey, according to the Associated Press.

In contrast to his explosive arrival at the courthouse, Mangione said nothing as deputies shuttled him to a waiting squad car after the 45-minute proceeding.

“You can’t rush to judgment in this case or any case,” Dickey told reporters afterward. “He’s presumed innocent. Let’s not forget that.”

Meanwhile, investigators fanned out across New York and Pennsylvania seeking to establish a timeline of Mangione’s whereabouts over the days since Thompson was gunned down Dec. 4 while arriving at United Healthcare’s annual investor conference in Midtown Manhattan.

Police have said that the killer managed to flee New York within 45 minutes of the shooting, first heading through Central Park on a bike, which he ditched on the Upper West Side. He then boarded a bus out of the city.

But what happened next remains unclear. Shapiro said Monday night that Mangione had been traveling from Philadelphia to Pittsburgh via Greyhound bus with stops along the way, including in Altoona, where he was arrested Monday nearly 300 miles from the Manhattan crime scene. Along the way, Mangione was “trying to stay low-profile” by avoiding cameras, Pennsylvania State Police Lt. Col. George Bivens said.

Still, Philadelphia Police Department officials expressed surprise Tuesday at the revelation that Mangione had apparently passed through the city. They remained tight-lipped about any role they might play in the investigation into how he spent his time here.

A department spokesperson declined to comment, referring all questions to the New York Police Department.

In Altoona, a regular customer at the McDonald’s where Mangione was eventually arrested told Fox News and the BBC one of his friends first spotted the suspected gunman there Monday morning.

“‘Well, that looks like the shooter from the New York,’” the man, whom news networks identified only as “Larry,” recalled his friend saying. “But the group of us thought it was more of a joke, and we were kidding about it.”

A restaurant employee overheard that conversation and called police. Officers found Mangione sitting at a table toward the back in a winter jacket and ski cap, wearing a blue medical mask, carrying a backpack, and using a laptop on the table in front of him, according to court documents released Monday.

The officers “immediately recognized him” from images New York City police had circulated of the person wanted in connection with Thompson’s shooting, they wrote in a criminal complaint. Images released Tuesday by the Pennsylvania State Police showed Mangione pulling down his surgical mask while holding what appeared to be hash browns.

They asked Mangione, they said, “if he had been to New York recently,” at which point he “became quiet and started to shake.”

When the officers asked him for identification, he initially gave them a fake New Jersey driver’s license in the name of “Mark Rosario,” the officers said — the same ID the suspected shooter used to check into a hostel in Manhattan before the shooting.

He eventually confessed his true identity and was taken into custody. Investigators discovered a black pistol and silencer that appeared to have been 3D-printed, a passport, and thousands of dollars in cash, $2,000 of it in foreign currency, Blair County prosecutors said. He also was carrying what officials described as a Faraday bag, which blocks the ability for digital devices to be tracked by location.

But Mangione disputed that during a Monday evening hearing before District Judge Benjamin F. Jones. He maintained he’d bought the bag because it was waterproof and said he did not know where the money found in his backpack came from, suggesting it might have been planted.

As for what may have motivated Mangione’s attack, possible answers began to emerge Tuesday.

A 262-word note Altoona police found in his possession at the time of his arrest criticized big businesses that “continue to abuse our country for immense profit because the American public has allowed them to get away with it.” It singled out UnitedHealthcare, noting that as the company’s profits have grown, American life expectancy has not.

“To save you a lengthy investigation, I state plainly that I wasn’t working with anyone,” the message read, adding: “I do apologize for any strife or traumas but it had to be done. Frankly, these parasites simply had it coming.”

An internal intelligence report drafted by the New York City Police Department in the hours since Mangione’s arrest, which was obtained by the New York Times, said Mangione “appeared to view the targeted killing of the company’s highest-ranking representative as a symbolic takedown and a direct challenge to its alleged corruption and ‘power games.’”

The memo said that, based on the writings found in Mangione’s possession, “he likely views himself as a hero of sorts who has finally decided to act upon such injustices.”

It remained unclear whether Mangione or anyone he knew had had a dissatisfactory outcome with UnitedHealthcare in the months leading up to Thompson’s slaying.

But his profile on the social media platform X features a photo of an X-ray of a spine with four large screws. And friends told news outlets, including the Associated Press, the New York Times, and the Washington Post, that Mangione suffered from a lifelong back injury that was exacerbated last year during his stint staying at a “co-living” space called Surfbreak in Honolulu, Hawaii.

Surfbreak founder R.J. Martin told the Times that Mangione had come to Hawaii in early 2022 hoping to build strength while surfing and rock climbing and that the pair often spoke about how his back injury weighed on his life.

“He knew that dating and being physically intimate with his back condition wasn’t possible,” Martin said. “I remember him telling me that, and my heart just breaks.”

After six months living at Surfbreak, Martin said, Mangione left to undergo surgery on the East Coast. He returned to an apartment in Honolulu, where he lived until this summer, Hawaii local news network KHON2 reported.

New York authorities said Tuesday the writings found in Mangione’s possession referenced his struggles with his spinal condition.

“Some of the writings that he had, he was discussing the difficulty of sustaining that injury,” New York Police Chief of Detectives Joe Kenny told Fox News. “So we’re looking into whether or not the insurance industry either denied a claim from him or didn’t help him out to the fullest extent.”

Six months before Thompson’s slaying, Mangione appeared to go dark. A once-avid social media user who frequently posted updates to platforms including X, Facebook, Instagram, and the book review site Goodreads, he suddenly stopped communicating.

“Nobody has heard from you in months, and apparently your family is looking for you,” one friend posted to his X account in October. “I don’t know if you are okay.”

The next month, Mangione’s mother filed a missing-person report in San Francisco, a city in which authorities said he also maintained ties.

By the time he reemerged this week — a target in a nationwide manhunt and a suspect in a brazen crime that captured the nation’s attention — few who knew him were willing to talk, especially under the glare of the national media spotlight.

» READ MORE: Who is Luigi Mangione, the ex-Penn student charged in the UnitedHealthcare CEO shooting?

Outside Baltimore, where Mangione had been raised as part of a prominent family — including a real estate developer grandfather who owned country clubs, nursing homes, and a radio station and a cousin who serves in the Maryland House of Delegates — relatives remained cloistered behind closed doors and issued a statement declining to comment.

Security guards sat parked outside the nearly 5,000-square-foot home, valued at $2 million, where Mangione’s parents, Louis and Kathleen, live on the grounds of a family-owned country club.

At the Gilman School — the exclusive, all-boys private school in Baltimore where annual tuition runs near $40,000 and where Mangione graduated as valedictorian in 2016 — students avoided reporters Tuesday, walking in clusters as groundskeepers blasted leaf blowers to shoo television news crews away.

Officials at a family-founded nursing home where Mangione once volunteered, and at a video game company where he had once interned, also declined to comment.

And at the University of Pennsylvania — where Mangione earned bachelor’s and master’s degrees in computer science between 2016 and 2020 — students and former classmates, inundated with attention from the national press, were reluctant to speak.

Still, one former student who lived in the Lauder House dormitory with Mangione during their freshman year and took computer science classes with him recalled his now-famous ex-classmate as the kind of guy who “would greet you with a smile if you passed him on the way to class.”

Mangione was involved in Greek life as a member of the Phi Kappa Psi fraternity, and served as a teaching assistant for a challenging technical undergraduate course, said the former classmate, who spoke on the condition of anonymity out of concern for his privacy.

“He was just some dude I had classes with,” the man said in an interview Tuesday. “And now he’s had this huge impact on the world.”

Staff writers Ellie Rushing, Oona Goodin-Smith, Susan Snyder, Ximena Conde, and Robert Moran contributed to this article, which contains information from the Associated Press.