Luigi Mangione, the man accused of gunning down a health insurance executive in Manhattan, plans to argue at his murder trial that he was undergoing an extreme mental health crisis at the time of the alleged killing, a judge revealed at a hearing on Wednesday.
The strategy poses steep legal hurdles but could lead to a jury convicting Mangione of the lesser crime of manslaughter, which carries significantly lighter sentences.
Mangione, who appeared in court in a dark suit and white shirt, is accused of fatally shooting UnitedHealthcare CEO Brian Thompson outside a hotel in Midtown in December 2024.
The brazen killing was widely condemned by public officials but became emblematic of Americans’ frustration with rising healthcare costs and health insurance industry practices.
Mangione pleaded not guilty in December 2024 to state murder, weapons and forgery charges brought by Manhattan District Attorney Alvin Bragg. His trial is set for September before Justice Gregory Carro in Manhattan.
Under New York law, murder defendants can seek to convince a jury that their actions can be explained by an “extreme emotional disturbance” that reduces their criminal culpability.

