The murder of UnitedHealthcare CEO Brian Thompson on a chilly morning in December 2024 sent shockwaves through New York’s business district and reverberated far beyond. Now, nearly nine months later, the legal battle surrounding the accused, Luigi Mangione, has grown into a fierce and tangled fight, pitting questions of privacy, motive, and legal process against the backdrop of a nation’s simmering frustration with the healthcare industry.
On August 19, 2025, Mangione’s defense attorneys filed a new salvo in Manhattan court, accusing prosecutors of improperly accessing their client’s private medical records. According to AP and other outlets, Mangione’s lawyers allege that the Manhattan district attorney’s office knowingly reviewed sensitive health information after insurance giant Aetna turned over documents in response to a subpoena. The defense insists that prosecutors gained access to diagnoses and statements Mangione made to doctors—potentially violating his HIPAA rights. The district attorney’s office, for its part, denies any wrongdoing, arguing that it only sought "entirely unremarkable" data such as Mangione’s account number and coverage history, and blaming Aetna for providing more than was requested. Aetna maintains it responded appropriately to the subpoena.
“A gaping, factual chasm exists between the explanations provided by the District Attorney's Office and Aetna,” Mangione’s attorneys wrote in their Tuesday court filing. They’re now pushing for an evidentiary hearing to unravel exactly how the subpoena was drafted, how Aetna was instructed to respond, who reviewed the records, and who oversaw the process. The answers, they say, could determine whether they seek to suppress evidence, move for the prosecution team’s recusal, or even aim to dismiss the indictment altogether.
But the privacy dispute is only one facet of a much broader legal drama. Mangione, 27, stands accused in both state and federal court of the brazen killing of Brian Thompson, who was shot from behind while arriving for an investor conference at the New York Hilton Midtown on December 4, 2024. Surveillance footage captured the masked gunman’s ambush, and police later revealed that the ammunition bore the words “delay,” “deny,” and “depose”—a chilling nod, prosecutors say, to the insurance industry’s reputation for denying claims. Mangione was apprehended five days later at a McDonald’s in Altoona, Pennsylvania, some 230 miles from the scene.
The prosecution’s case leans heavily on Mangione’s own words. On August 20, 2025, prosecutors revealed in a new filing that, six weeks before the murder, Mangione had written in his diary about rebelling against what he called “the deadly, greed fueled health insurance cartel.” He mused that killing an insurance executive “conveys a greedy bastard that had it coming.” The diary, described by prosecutors as a manifesto, also included praise for Ted Kaczynski—the Unabomber—and detailed Mangione’s deliberations over how to carry out his attack. He considered bombing UnitedHealthcare’s headquarters before settling on targeting the company’s annual investor conference in Manhattan. “Wack the CEO at the annual parasitic bean-counter convention,” he wrote, explaining that it would be “targeted, precise and doesn’t risk innocents.”
In a separate confession addressed “To the feds,” Mangione reportedly wrote, “it had to be done.” Prosecutors argue that these writings make his intentions explicit: “The murder of Brian Thompson was intended to bring about revolutionary change to the healthcare industry.” They add, “This brutal, cowardly murder was the mechanism that defendant chose to bring on that revolution.” The company, for its part, has said Mangione was never a client.
Manhattan District Attorney Alvin Bragg has been unequivocal in his assessment, describing the murder as “a killing that was intended to evoke terror.” Federal authorities have taken a similarly hard line. In April, U.S. Attorney General Pam Bondi announced that federal prosecutors would seek the death penalty, calling the crime “an act of political violence” and “a premeditated, cold-blooded assassination that shocked America.”
The state and federal cases, however, have created a legal quagmire. Mangione’s lawyers argue that pursuing both amounts to double jeopardy and have asked for the state terrorism charges to be dismissed. They also want the federal case to proceed first and are seeking to suppress evidence obtained during Mangione’s arrest—including the 9mm handgun, his statements to police, and the diary. According to court documents, the state charges focus on Mangione’s alleged intent to “intimidate or coerce a civilian population,” namely insurance employees and investors, while the federal charges center on stalking and do not include terrorism allegations. Prosecutors maintain that there is no double jeopardy, as neither case has gone to trial and they involve distinct legal theories.
No trial dates have been set for either case. Mangione’s next state court appearance is scheduled for June 26, 2025, when Judge Gregory Carro is expected to rule on the defense’s request for dismissal. The following federal court date is set for December 5, 2025, a day after the one-year anniversary of Thompson’s death. In the meantime, Mangione remains in federal custody at a jail in Brooklyn. His lawyers have also asked that his handcuffs and bulletproof vest be removed during hearings, arguing that such security measures could prejudice potential jurors. “He is a model prisoner, a model defendant,” they told the court, but Judge Carro has yet to rule on the request.
The killing and the ensuing manhunt rattled New York’s business community and sent a chill through the world of corporate America. At the same time, the case has galvanized critics of the health insurance industry. Some have rallied around Mangione, seeing him as a symbol of deep-seated frustration over denied claims and soaring medical bills. Supporters have flocked to his court appearances and sent him a flood of mail, reflecting a broader anger at the state of American healthcare—though many others have condemned the violence in the strongest terms.
As the legal wrangling continues, questions about privacy, due process, and the limits of protest swirl around the case. The defense’s push for a hearing on the handling of Mangione’s medical records underscores the high stakes, not just for the accused but for the criminal justice system’s handling of sensitive information. Meanwhile, the prosecution’s reliance on Mangione’s own words—his diary, his confession, his chilling references to “revolution”—lays bare a motive that, prosecutors argue, goes far beyond personal grievance.
For now, the city waits. The business world, the healthcare industry, and Mangione’s supporters and detractors alike are left to watch as the courts grapple with a case that has become a flashpoint in the ongoing debate over healthcare, privacy, and political violence in America.
