HOLLIDAYSBURG, Pa. — The 26-year-old man accused of killing a health care executive in New York City agreed Thursday to be extradited to New York, where he will face a first-degree murder charge.

The man, Luigi Mangione, was being held at a prison in Pennsylvania after he was spotted in a McDonald’s in the central part of the state and arrested by local police. The Manhattan district attorney’s office sought to bring him to New York to prosecute him for the death of Brian Thompson, the CEO of UnitedHealthcare. In charging documents, prosecutors have characterized the killing as an “act of terrorism” because it was intended, they say, to influence government policies and intimidate civilians.

After his arrest last week, Mangione initially indicated through his lawyer that he would contest extradition to New York. Mangione has been represented by a lawyer in Pennsylvania, but he has also hired a prominent New York defense lawyer who formerly worked as a top prosecutor in the Manhattan district attorney’s office.

Since he is no longer contesting extradition, Mangione is expected to be transported to a New York City jail to await arraignment, which would most likely take place Friday.

New York City police have said Mangione waited outside a hotel a short walk from Times Square and shot Thompson several times early on the morning of Dec. 4, when the executive was on his way to an investor meeting. The brazen killing prompted a five-day search that ended in Altoona, Pennsylvania, where Mangione was captured while eating breakfast in McDonald’s after he was unable to get a room at a nearby motel.

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Mangione Called Health Insurance Industry Workers ‘Parasites’

The authorities said that at the time of his arrest, Mangione had a gun with him that matched the shell casings left at the crime scene. They also said he had a document with him that decried “parasites” — apparently referring to people working in the health insurance industry — and said that he had acted alone.

The targeting of a top health executive has prompted discussion about Americans’ frustrations with the high cost and chronic dysfunction of the country’s health care system, and in particular, the practices and profits of health insurance companies.

In some corners, Mangione was lauded as something of a hero, a characterization that has been denounced by community leaders and law enforcement officials. Jessica Tisch, the commissioner of the New York Police Department, said she was appalled by the “celebration of coldblooded murder.”

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Mangione, a computer engineer who grew up in a Baltimore suburb, has not spoken publicly since he was arrested, except for a moment last week when he shouted to reporters as he was being taken into a courthouse by sheriff’s deputies. In that outburst, he said something was “completely out of touch, and an insult to the intelligence of the American people” and made a reference to “lived experience.” It was not clear to what he was referring. (The sheriff of Blair County, whose deputies were escorting Mangione at the time, said Mangione had told him he was upset with the news media.)

Thompson lived in a Minneapolis suburb and had been with UnitedHealthcare for more than 20 years. He became its CEO in 2021. The company made $16 billion in profits last year, and Thompson was paid more than $10 million in total compensation.

United has said that neither Mangione nor his family had health insurance coverage through the company.

Mangione told friends that he suffered from back pain and underwent surgery for the problem in the summer of 2023. He later reported on Reddit that the operation was a success.

Little is known about how Mangione spent the last six months. He lived in Hawaii for some time before going on a trip to Asia, with stops in Thailand and Japan, according to people who knew him. His friends and family tried to contact him during those months but could not reach him.

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This article originally appeared in The New York Times.

By Nicholas Bogel-Burroughs/Rachel Wisniewski
c. 2024 The New York Times Company