Luigi Mangione has been charged with first degree murder as an act of terrorism over the killing of healthcare CEO Brian Thompson.
Announcing the charges, New York District Attorney Alvin Bragg called the shooting “frightening, well-planned and targeted”.
Mangione, 26, is already accused of the UnitedHealthcare boss Thompson’s murder on December 4, but the terror allegation is new.
He is scheduled to appear for a court hearing on Thursday over whether he will be extradited to New York on the charges.
Mangione was arrested five days later at a McDonald’s restaurant in Altoona, Pennsylvania, with a so-called “ghost gun” and fake ID, police said.
Under New York law, such a terrorism charge can be brought when an alleged crime is “intended to intimidate or coerce a civilian population, influence the policies of a unit of government by intimidation or coercion and affect the conduct of a unit of government by murder, assassination or kidnapping”.
Thompson, 50, was shot dead as he walked to a Manhattan hotel where Minnesota-based UnitedHealthcare - the United States’ biggest medical insurer - was holding an investor conference.
Bragg told reporters at a news conference on Tuesday: “This was a frightening, well-planned, targeted murder that was intended to cause shock and attention and intimidation.
“It occurred in one of the most bustling parts of our city, threatened the safety of local residents and tourists alike, commuters and businesspeople just starting out on their day.”
Mangione’s Pennsylvania lawyer has said his client would fight extradition to New York where he is likely to be held at Riker’s Island or another prison.
Investigators’ working theory is that Mangione, an Ivy League computer science grad from a prominent Maryland family, was propelled by anger at the US health care system.
He was carrying a handwritten letter that called insurance companies “parasitic” and complained about corporate greed.
Mangione repeatedly posted on social media about how spinal surgery last year had eased his chronic back pain, encouraging people with similar conditions to speak up for themselves if told they just had to live with it.
He was never a UnitedHealthcare client, according to the insurer.
Mangione apparently cut himself off from his family and close friends in recent months. His relatives reported him missing to San Francisco authorities in November.
He remains under maximum security at Huntingdon State Correctional Institution in Huntingdon County, Pennsylvania.
Thompson, who grew up on a farm in small-town Iowa, was trained as an accountant.
A married father of two high-schoolers, he had worked at the giant UnitedHealth Group for 20 years and became CEO of its insurance arm in 2021.
