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Authorities say Mangione gunned down Thompson as he was walking to an investor conference in midtown Manhattan on the morning of Dec 4.

Mangione was arrested in a Pennsylvania McDonald’s after a five-day search, carrying a gun that matched the one used in the shooting and a fake ID, police said. He also was carrying a notebook expressing hostility toward the health insurance industry and especially wealthy executives, according to federal prosecutors.

At a news conference last week, Manhattan District Attorney Alvin Bragg said the application of the terrorism law reflected the severity of a “frightening, well-planned, targeted murder that was intended to cause shock and attention and intimidation.”

“In its most basic terms, this was a killing that was intended to evoke terror,” he added.

Mangione is being held in a Brooklyn federal jail alongside several other high-profile defendants, including Sean “Diddy” Combs and Sam Bankman-Fried.

During his court appearance Monday, he smiled at times when talking with his attorneys and stretched his right hand after an officer removed his cuffs.

Outside the courthouse, a few dozen supporters chanted, “Free Luigi,” over the blare of a trumpet.

Natalie Monarrez, a 55-year-old Staten Island resident, said she joined the demonstration because she lost both her mother and her life savings as a result of denied insurance claims.

“As extreme as it was, it jolted the conversation that we need to deal with this issue,” she said of the shooting. “Enough is enough, people are fed up.”

An Ivy-league graduate from a prominent Maryland family, Mangione appeared to have cut himself off from family and friends in recent months. He posted frequently in online forums about his struggles with back pain. He was never a UnitedHealthcare client, according to the insurer.

Thompson, a married father of two high-schoolers, had worked at the giant UnitedHealth Group for 20 years and became CEO of its insurance arm in 2021.

The killing has prompted some to voice their resentment at U.S. health insurers, with Mangione serving as a stand-in for frustrations over coverage denials and hefty medical bills. It also has sent shockwaves through the corporate world, rattling executives who say they have received a spike in threats.