UnitedHealth murder suspect has angry outburst as details of his life emerge

Mangione, 26, turned toward a group of reporters and yelled in part, "...completely out of touch and an insult to the intelligence of the American people!" before deputies pushed him away. It was not clear to what he was referring.

At the court hearing, his defense lawyer told a judge that Mangione would oppose extradition to New York, where he is charged with murder and other crimes. That decision could delay the process by weeks but is unlikely to block his eventual transfer; for now, Mangione will remain in jail in Pennsylvania, where he faces gun and forgery charges.

His attorney, Tom Dickey, said at a news conference that Mangione planned to plead not guilty to the charges.

Brian Thompson, the CEO of UnitedHealth's insurance arm, one of the largest health insurers in the U.S., was shot dead on the morning of Dec. 4 outside a hotel in Manhattan in what police said was a targeted attack, sparking a manhunt that led to Mangione's arrest.

More clues about his possible motivation were coming to light on Tuesday.

When arrested, Mangione was in possession of a handwritten manifesto that offered insight into his mindset, according to police. The New York Times reported that an internal New York City Police report analyzing the document concluded that Mangione viewed the killing as a justified response to what he believed to be corruption in the healthcare industry.

"These parasites simply had it coming," the manifesto said, according to the Times.

Mangione suffered from chronic back pain that limited his daily life, according to friends, his social media postings and other news reports. His profile on X shows a background image of an x-ray with what appears to be screws and plates inserted in a lower back.

An employee at TrueCar told Reuters that Mangione worked at the car-buying website as a data engineer from 2022 to late 2023. In mid-2023, Mangione took about two months off for what the employee's manager described as back-related issues.

The employee, who asked not to be named, described Mangione as "incredibly smart" and very friendly to his co-workers.

He said that the company offered employees health insurance through UnitedHealth as well as other choices, such as Aetna.

From January through June 2022, Mangione lived at the Surfbreak co-living community in Honolulu, where he led a book club and surfed, hiked and rock-climbed, the founder of the group, R.J. Martin, told the Hawaiian outlet Civil Beat.

Martin said Mangione had suffered back pain caused by misaligned vertebrae pinching Mangione's spinal cord, and he left for the mainland at some point for surgery.

But he went "radio silent" in June or July, Martin told Civil Beat.

Mangione never showed any indication of violence, Martin later told MSNBC.

"The Luigi that I knew is completely incompatible with an assassin," he said, describing him as funny, kind and thoughtful.

At one point, Mangione suggested Surfbreak's book club read the manifesto of Ted Kaczynski - the U.S. domestic bomber known as the Unabomber - as a joke, according to Martin.

On the book-themed social media site Goodreads, a poster with Mangione's name praised Kaczynski's book "Industrial Society and Its Future" as "prescient" about modern society, called him an "extreme political revolutionary" and suggested violence was a legitimate form of resistance in some circumstances.

GHOST GUN, BRAZEN ESCAPE

Mangione was spotted at a McDonald's on Monday by an employee who thought he looked like the gunman in surveillance images released by police.

Mangione, an Ivy League graduate who was also the valedictorian of a private all-boys school in Maryland, had a loaded ghost gun - an untraceable firearm assembled from parts - and a silencer, officials said on Monday. Both the weapon and his clothing closely resembled those used by the gunman.

He also had multiple fake identifications, including a fraudulent New Jersey ID that matched the one used by the gunman to check into a Manhattan hostel days before the shooting, according to authorities.

Mangione's family released a statement saying they knew only what had been reported in the media.

"Our family is shocked and devastated by Luigi's arrest," the family said in a statement posted to the X account of Maryland lawmaker Nino Mangione. "We offer our prayers to the family of Brian Thompson and we ask people to pray for all involved."

The gunman managed to elude capture for days after the attack last Wednesday outside the Hilton hotel in midtown Manhattan.

Thompson's murder unleashed a wave of frustration from Americans struggling to afford medical care and those who have been denied claims or care.

Thompson, a father of two, had been CEO of UnitedHealthcare since April 2021, part of a 20-year career with the company. He had been in New York to attend the company's annual investor conference.