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Man accused of killing UnitedHealthcare's CEO shouts on way into courthouse and fights extradition

ALTOONA, Pa.
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Suspect Luigi Mangione is taken into the Blair County Courthouse on Tuesday, Dec. 10, 2024, in Hollidaysburg, Pa. (Benjamin B. Braun/Pittsburgh Post-Gazette via AP)

ALTOONA, Pa. (AP) 鈥 The man charged with murder in the killing of the made it clear he wasn鈥檛 going to make things easy on authorities, shouting unintelligibly and writhing in the grip of sheriff鈥檚 deputies as he was led into court and then objecting to being brought to New York to face trial.

The displays of resistance Tuesday weren鈥檛 expected to significantly delay legal proceedings for , who was charged in last week鈥檚 Manhattan killing of , the leader of the United States鈥 largest medical insurance company. Little new information has come out about possible motivation, though writings found in Mangione's possession hinted at a vague hatred of corporate greed.

In his first public words since he was arrested at a McDonald鈥檚 in Pennsylvania after a five-day search, the 26-year-old Ivy League graduate from a prominent Maryland real estate family emerged from a patrol car shouting about an 鈥渋nsult to the intelligence of the American people鈥 while deputies pushed him inside a courthouse.

A law enforcement bulletin obtained by The Associated Press said that at the time of his arrest, Mangione was carrying a handwritten document expressing anger with what he called 鈥減arasitic鈥 health insurance companies and a disdain for corporate greed and power.

He wrote that the U.S. has the most expensive health care system in the world and that profits of major corporations continue to rise while 鈥渙ur life expectancy鈥 does not, according to the bulletin.

Mangione remained jailed in Pennsylvania, where he was initially charged with possession of an unlicensed firearm, forgery and providing false identification to police.

Manhattan prosecutors were beginning to take steps to bring Mangione to New York, but at a brief hearing Tuesday, defense lawyer Thomas Dickey said his client will not waive extradition and instead wants a hearing on the issue. Mangione was denied bail after prosecutors said he was too dangerous to be released.

He mostly stared straight ahead at the hearing, occasionally looking at papers, rocking in his chair or looking back at the gallery.

鈥淵ou can鈥檛 rush to judgment in this case or any case,鈥 Dickey said afterward. 鈥淗e鈥檚 presumed innocent. Let鈥檚 not forget that.鈥

Mangione was arrested in Altoona, Pennsylvania, about 230 miles (about 370 kilometers) west of New York City, after a McDonald鈥檚 customer recognized him and notified an employee, authorities said.

New York police officials have said Mangione was carrying like the one used to kill Thompson and the same fake ID the suspected shooter had used to check into a New York hostel, along with a passport and other fraudulent IDs.

A law enforcement official who wasn鈥檛 authorized to discuss the investigation publicly and spoke with The Associated Press on condition of anonymity said a three-page, handwritten document found with Mangione included a line in which he claimed to have acted alone.

鈥淭o the Feds, I鈥檒l keep this short, because I do respect what you do for our country. To save you a lengthy investigation, I state plainly that I wasn鈥檛 working with anyone,鈥 the document said, according to the official.

Thompson, 50, was killed Dec. 4 as he walked alone to a Manhattan hotel for an investor conference. From surveillance video, New York investigators determined the shooter quickly fled the city, likely by bus.

Mangione was born into a life of country clubs and privilege. His grandfather was a self-made real estate developer and philanthropist.

鈥淥ur family is shocked and devastated by Luigi鈥檚 arrest,鈥 Mangione鈥檚 family said in a statement posted on social media late Monday by his cousin, Maryland Del. Nino Mangione. 鈥淲e offer our prayers to the family of Brian Thompson and we ask people to pray for all involved.鈥

From January to June 2022, Luigi Mangione lived at Surfbreak, a 鈥渃o-living鈥 space at the edge of touristy Waikiki in Honolulu. Josiah Ryan, a spokesperson for owner and founder R.J. Martin, said he was widely considered a 鈥済reat guy," though he had long dealt with severe back pain that interfered with many aspects of his life.

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Scolforo reported from Altoona and Hollidaysburg, Pennsylvania. Contributing were Associated Press writers Cedar Attanasio and Jennifer Peltz in New York; Michael Rubinkam and Maryclaire Dale in Pennsylvania; Lea Skene in Baltimore; Jennifer Sinco Kelleher in Honolulu and John Seewer in Toledo, Ohio.

Michael R. Sisak And Mark Scolforo, The Associated Press