Attorney General Pam Bondi announced Tuesday that federal prosecutors will seek the death penalty in Luigi Mangione’s case.
Mangione’s case has slowly wound through the criminal legal system since December, when the 26-year-old allegedly gunned down UnitedHealthcare CEO Brian Thompson.
In the aftermath of the shooting, manhunt, and eventual arrest, Mangione faces legal action across three separate jurisdictions.
The State of New York, where the attack took place, indicted Mangione for murder in the first and second degree, plus forgery and gun-related offenses. First-degree murder is a rare charge in the state, and prosecutors had to justify his crime as an act of terrorism. Mangione faces life in prison without parole in that case if he is convicted.
Meanwhile, the federal government is bringing its own criminal case against Mangione, in which the U.S. Justice Department charged Mangione with stalking and murder through use of a firearm.
He will eventually face lesser charges in Pennsylvania, where he was arrested, once the murder investigation finishes. Federal agents originally took him into custody, but his New York trial is now slated to happen first, according to CNN.
Yet the issues that Mangione’s actions thrust into the national spotlight — namely, unequal access to health care and unfair insurance practices — are no less present than the day Thompson was shot.
Health disparities that fall along racial and ethnic lines are particularly pronounced in the United States, especially for Black and Native Americans, according to a 2024 report from The Commonwealth Fund.
These populations were never homogenous, but when viewed as a demographic for broad analysis, they show lower life expectancy across the board, as well as higher risks of pregnancy complications, dying from a treatable condition, infant mortality, and a number of chronic diseases, such as diabetes and hypertension.
Shaping this reality are all kinds of barriers to health care, from prohibitive costs to the medical racism that led to Black patients receiving “worse care than white patients on 52 percent of quality measures in 2023,” per The Commonwealth Fund’s report.
Black, Hispanic, and Native people are also more prone to be uninsured, delay care due to costs, incur health care debt, and not have a primary care doctor than other groups, the analysis found.
Speaking of insurance, the racial inequities that exist in coverage could worsen under the Trump administration’s likely cuts to Medicaid, Medicare, and Marketplace plans. That’s because Black, Native, Hispanic, and Hawaiian/Pacific Islander populations are already disproportionately using these policies, according to a KFF study.
Granted, things got a bit better at multiple points in the last decade before declining. The Affordable Care Act gave underinsured groups a serious boost, though rates began slipping again in 2017. Then came the pandemic, and with it, helpful policies like continuous Medicaid enrollment and enhanced Marketplace subsidies. Coverage gaps were somewhat stabilizing, yet the gains were not for long. Those Covid-era lifelines have since eroded, and disparities are once again widening, as KFF’s study shows using data visualization.
Other factors include gaps in eligibility for immigrant families and the fact that many southern states, which have a higher share of the Black population, have not opted in to an expanded version of Medicaid.
To improve health outcomes and close coverage gaps for people of color, The Commonwealth Fund offered some starting points for policymakers. They include strengthening primary care and service delivery, reducing harmful administrative burdens, investing in social services, and working toward a “universal, affordable and equitable health coverage.”
The lack of that kind of coverage in the current health system, and the presence of rampant for-profit monopolies instead, is part of what prosecutors believe angered Mangione to such a degree.
The Trump administration has not announced many plans that seek to improve the situation, and overall, deregulation seems to be the chosen policy direction. For example, the president signed an executive order that rolled back initiatives to lower the cost of prescription drugs — though he also signed another directive aimed at boosting price transparency.
In any case, Mangione’s forthcoming trials are sure to continue driving news around what’s broken in American health care.
While the death penalty is outlawed in the state of New York, the federal case always had the potential to involve capital punishment. However, it was not clear whether Bondi would sign off on it until this week. Now, federal prosecutors’ intent to seek a death penalty sentence if given the chance is official.
The move falls in line with President Donald Trump’s stated desire to employ the punishment more often, in spite of Joe Biden commuting the sentences of many death row inmates before leaving office. Trump, on the other hand, greenlit the executions of 13 inmates in his first term, marking the first uses of capital punishment at the federal level in nearly two decades, CNN reported.
Mangione’s legal team was already preparing for the possibility, according to his attorney Karen Friedman Agnifilo. Avraham Moskowitz, an attorney specializing in death penalty cases, also joined the defense.
The next hearing in the New York case is set for June 26. Mangione recently released a statement from prison to thank his supporters, who have raised over $800,000 for his legal bills as of Wednesday.
“I am overwhelmed by – and grateful for – everyone who has written me to share their stories and express their support,” the statement reads, per CNN. “While it is impossible for me to reply to most letters, please know that I read every one that I receive.”
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