They may still be several months off, but how the criminal trials Luigi Mangione will face for the shooting death of UnitedHealthcare CEO Brian Thompson in 2024 might play out are coming into focus. For the New York state murder trial, the reveal of the defense plan by his attorney, Karen Friedman Agnifilo, marked a first in the legal proceedings — an indication that the defense will not contest that Mangione was the shooter while still contesting his level of culpability.
A pretrial hearing on June 17, 2026, included the defense’s intent to offer a psychiatric defense based on Mangione’s “extreme emotional disturbance” (EED) at the time of the shooting. Mangione, who has pleaded not guilty to all charges against him, is currently facing second-degree murder charges in New York, which carry a potential sentence of 25 years to life. If jurors find that Mangione acted under an extreme emotional disturbance, New York law would require them to reduce what would otherwise be a murder conviction to first-degree manslaughter, which carries a maximum of 25 years instead of a potential life sentence. In federal court, Mangione still faces stalking charges, but the murder and weapons counts that could have exposed him to the death penalty were dismissed in January 2026, though he remains at risk of a life‑without‑parole sentence if convicted of stalking.
While Agnifilo had alerted Judge Gregory Carro in September 2025 to the intent to use a psychiatric defense, the Manhattan District Attorney’s Office has accused the defense team of dragging its feet in providing details about what allegedly triggered Mangione, hampering their preparations. At the pre-trial hearing, Judge Carro announced that the court would unseal redacted transcripts from a hearing about Mangione’s proposed defense on June 3.
Given what’s known about the details of the case, offering an EED defense is a bold move. It all but concedes that Mangione pulled the trigger, while asking jurors to downgrade his culpability from murder to manslaughter instead of acquitting him outright.
In a New York State of Mind
On December 4, 2024, Thompson was shot and killed by a masked person outside the New York Hilton Midtown hotel. The gun used to kill him had a silencer, and bullet casings recovered at the scene had “delay,” “deny,” and “depose” written on them, an approximation of tactics employed by the healthcare industry when refusing to pay claims made by their clients. Mangione was arrested five days later in a McDonald’s in Pennsylvania, more than 275 miles from New York City. Among other evidence, his fingerprints matched those on the shell casings and other items found at the scene of the shooting.
In addition to the 11 charges filed by the state of New York, Mangione was indicted on multiple federal charges, which included two firearm charges. One was a murder charge that offered the potential of the death penalty. However, in January 2026, U.S. District Judge Margaret Garnett dismissed the murder and weapons counts on legal grounds, eliminating the possibility of a federal death sentence while leaving the stalking charges in place.
On the state level, a judge dismissed both murder charges that were linked to terrorism, leaving a lone second-degree murder charge along with several charges related to criminal possession of a weapon and a forged instrument (in this instance, false identification). During a February hearing, Mangione groused about facing “double jeopardy” with both state and federal charges for the same alleged crime.
The defense raised questions over potential violations of Mangione’s protections against the improper search and seizure of his backpack and his Miranda rights. These led to lengthy Mapp and Huntley hearings, and a later suppression hearing excluded an ammunition clip but allowed Mangione’s notebooks, which include checklists, reminders, and a “manifesto.” This may prove to be the most difficult hurdle for his defense team to overcome.
A Moment of Irrational Distress or a Carefully Plotted Murder?
Mangione’s proposed EED defense seems likely to adopt a “heat of passion” stance, arguing that a triggering moment caused a profound loss of self-control that led to Thompson’s homicide. The tricky part will be countering the evidence that may support the theory that Mangione planned and stalked Thompson before shooting him. While a person walking in on a spouse in bed with a lover is often used as an example for a killing made without forethought or planning, it may be challenging for the defense to convince a jury that a spontaneous reaction was also the case with Mangione.
Because EED is not an insanity defense, Mangione’s lawyers do not have to prove that he met New York’s strict legal test for insanity or that he suffered from a particular diagnosed disorder, though they are expected to rely heavily on psychiatric evidence.
However, they’ll likely need to focus on something that allegedly made him snap. It also means that even if the jury credits the EED theory, he would still serve a standard criminal sentence in state prison rather than be committed under an insanity‑acquittal framework. They’ll also need a different approach for the stalking charges in his federal trial, which starts in October.
