The 11-count indictment includes three murder charges, including murder as an act of terrorism.

The 11-count indictment includes three murder charges, including murder as an act of terrorism.

The 11-count indictment includes three murder charges, including murder as an act of terrorism.

New York: Luigi Mangione, the man accused of fatally gunning down UnitedHealth Group chief executive Brian Thompson on a Manhattan street, pleaded not guilty on Monday to state murder charges that brand him a terrorist.

The 11-count indictment includes three murder charges, including murder as an act of terrorism. If convicted, he faces a maximum sentence of life in prison without the possibility of parole.

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Monday's arraignment at New York state criminal court in Manhattan was the second court appearance in New York for Mangione, 26, since he was arrested at a McDonald's restaurant in Altoona, Pennsylvania, five days after the brazen, pre-dawn December 4 killing of Thompson outside a hotel in midtown Manhattan where his company was gathering for an investor conference.

Mangione also faces a four-count federal criminal complaint charging him with stalking and killing Thompson. He has not yet been asked to enter a plea to those charges. US Magistrate Judge Katharine Parker ordered Mangione detained at a December 19 presentment on those charges. More than two dozen public members sat in the courtroom's audience where Mangione was presented.

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A small group of protesters had gathered outside the lower Manhattan courthouse in sub-freezing temperatures, expressing support for Mangione and anger at healthcare companies. One person held a sign saying "DENY, DEFEND, DEPOSE," the words police say were found etched on shell casings at the crime scene. The words echo tactics some accuse insurers of using to avoid paying out claims.

While public officials have condemned the killing of Thompson, Mangione has been feted as a folk hero by some Americans who decry the steep costs of healthcare and the power held by insurance companies to deny paying for some medical treatments.

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A Notebook Entry
The federal charges would make him eligible for the death penalty, should the US Attorney's office in Manhattan decide to pursue it. The separate federal and state cases will proceed in parallel. Federal prosecutors said the state case is expected to go to trial first.

Mangione's lead lawyer, Karen Friedman Agnifilo, said at the federal court hearing that the two charges were based on conflicting theories. The state charges accuse Mangione of intending to "intimidate or coerce a civilian population" and influence policy, while the federal charges accuse him of stalking and killing an individual.

Friedman Agnifilo said the two cases seemed completely different, and she asked prosecutors to clarify whether both would continue. Dominic Gentile, a federal prosecutor, said Thursday's initial appearance was not the appropriate time to address those legal arguments.

According to the federal criminal complaint, the police who arrested Mangione found a notebook that contained several handwritten pages that "express hostility towards the health insurance industry and wealthy executives in particular." A notebook entry dated October 22 allegedly described an intent to "wack" the chief executive of an insurance company at its investor conference.