In a case that has gripped the public and reignited anger over the US health insurance system, Luigi Mangione admitted in court that he fatally shot a top insurance executive and pleaded guilty to two federal stalking charges tied to the killing of UnitedHealthcare CEO Brian Thompson.
The guilty plea is expected to head off a federal trial in the high-profile matter, which drew swift condemnation from public officials even as it came to symbolize many Americans’ frustrations with health insurance industry practices.
The move may also open a path for Mangione to try to dismiss state murder charges and could slow the clock on an upcoming state trial.
US District Judge Margaret Garnett warned Mangione that a guilty plea carries steep consequences, including a maximum sentence of life in prison on each count.
Judge Garnett scheduled sentencing for 18 December. Mangione’s lawyer, Karen Friedman Agnifilo, said there was no plea agreement with prosecutors.
Watch: Mangione’s lawyers arriving at New York court amid high security
Mr Thompson led UnitedHealth Group’s insurance unit before he was shot dead in the early morning of 4 December 2024, outside the hotel where an investor conference was taking place.
Mr Thompson’s widow sat in the front row of the gallery alongside other members of his family.
Speaking in court, Mangione, 28, said he researched details of UnitedHealthcare’s annual investor conference in December 2024 after suffering a broken back and then navigating the health insurance system.
He said he later used a 3-D printer to make part of a gun and traveled to New York with the intent of killing Mr Thompson.
“I shot Mr Thompson in Manhattan and he died,” Mangione said.
Graphic footage of the killing, followed by a five-day hunt for a suspect, kept the case in the headlines and fueled intense attention online.
Mangione was arrested in Pennsylvania.
He had previously pleaded not guilty in April 2025 to murder, weapons and stalking charges brought by Manhattan federal prosecutors.
Judge Garnett threw out the murder and weapons charges over legal technicalities in a surprise ruling in January 2026.
Luigi Mangione was arrested in Pennsylvania in 2024
That decision removed the prospect of the death penalty in the federal case, but Mangione still faced the possibility of life without parole if convicted on the remaining stalking charges.
His federal trial was most recently set for January.
In a separate prosecution, Mangione pleaded not guilty in December 2024 to state terrorism, murder, weapons and forgery charges filed by Manhattan District Attorney Alvin Bragg.
A judge dismissed the terrorism charges in September 2025.
The state case is scheduled for trial on 8 September before Justice Gregory Carro in Manhattan.
If convicted of second-degree murder, Mangione would face 25 years to life in prison.
With the federal guilty plea now entered, Mangione could attempt to have the state murder charge thrown out under New York’s double jeopardy law, which bars someone from being prosecuted twice for the same conduct.
Mr Bragg’s office would oppose such an effort, maintaining that the murder charge is legally distinct from the federal counts.
Whichever side loses would likely pursue an emergency appeal.
