Mangione Episode 4: "Free Luigi"

Hi, this is Brian Buckmire, here with. another weekly episode of my new podcast. from ABC Audio and 20/20, Burden of. Proof: Luigi Mangione. Remember, you can also listen ad-free by. subscribing to 20/20 and True Crime Plus. on Apple Podcasts. Click the link in the. description to learn more. Now, here's. the next episode of Burden of Proof: Luigi Mangione. >> The defendant committed this murder. in an attempt to draw public attention.

to his dislike of certain businesses. >> This is Jamie McDonald, the United. States Attorney for the Southern. District of New York. He's speaking at a. press conference after Luigi Mangione. pleaded guilty in a federal court to two. counts of stalking and admitted to. shooting Brian Thompson. >> We live in a civilized society. governed by the rule of law. We debate, we disagree, we protest. We do not. commit murder. No grievance, political belief, or.

ideological cause can ever justify. murder. There can be no celebrity in. assassination. >> Brian Thompson's family, United. Healthcare executives, and law. enforcement attended the plea hearing. And so did two rows of Luigi Mangione. supporters. >> Any person who celebrates, encourages, or excuses actions like these is. fundamentally wrong. >> Through all the changes in this case,

going all the way back to December 2024, one thing has been consistent. Luigi. Mangione has vocal supporters. And many of them see him as emblematic. of rage against the US healthcare. system. >> I was really proud that even when. admitting his guilt, Luigi [music]. was able to find a way to still put the. spotlight. on an industry. that is so unfair.

>> How did the killing of one man become a. flash point for widespread frustration. with America's [music] healthcare. industry? From ABC Audio and 20/20, [music]. I'm Brian Buckmire, an attorney and ABC. News legal analyst. And this is Burden. of Proof, Luigi Mangione. Episode 4, Free Luigi. In a quiet part of Baltimore in a.

one-story brick shopping center, there's. a pizza shop called Vito's Pizza. >> We have a good the reputation of. good pizza. and we have a sub, pasta, a little bit. of. Italian menus. >> That's Maria Mantova. She and her. husband, Giuseppe, who are in their 60s, own Vito's Pizza. We spoke to them months before Luigi. Mangione's guilty plea and admission. The Mantovas say that back when Mangione.

was a student at Gilman in the 2010s, Vito's would get a lot of Gilman boys. ordering pizzas and subs. In December 2024, the Mantovas heard. Luigi Mangione was the police's number. one suspect in Brian Thompson's murder. Maria says that a few days after the. news broke, her daughter came across a. meme online, a part illustrated, part. AI-generated image of Saint Luigi. >> This picture of Luigi Mangione in the. vest of a saint.

>> Maria's daughter printed out the picture. and showed it to her parents. They all. got a kick out of it at the time. To the. Mantovas, who are Roman Catholic, it was. funny. Giuseppe asked his daughter to make a. couple copies. She did and he hung one. up in the storefront right above the. register. A local journalist posted about Saint. Luigi at Vito's. >> And then uh from there. started all the dramas, I would say.

>> [music]. >> Social media seized on the post with. users commenting, liking, and sharing. it. It generated over 6 million views. And quickly, the online frenzy spilled. out into the real world. At the time, Maria said the shop was flooded with. customers who wanted to support the. business and, >> [music]. >> according to her, make sure that picture. of St. Luigi stayed up. Though, keep in mind, this was long. before Mangione admitted to the. shooting. But there was also backlash online and.

in person. Maria said some people. accused the pizza shop of supporting. Mangione who at the time was still a. suspect. >> Started to be a. political so political thing. which there was no intention about that. >> And this is just one example of the. explosion of online commentary. surrounding Brian Thompson's murder. Jia Tolentino, a staff writer at The New. Yorker, says the reactions to Thompson's. killing indicated at the time that many.

Americans believe the private health. care system is a quote large-scale. purveyor of death. >> The CEO of a giant corporation gets shot. on the street and people celebrate it. as if a violent, murderous dictator had. just been taken out by a military team. >> There were some messages expressing. sympathy for Brian Thompson and his. loved ones, but there were also jokes, sarcasm, and laughter. Lots of laughter.

In fact, tens of thousands of social. media accounts reacted with a laugh on. Facebook to United Health Group's. official announcement of Brian's death. Folk artist Jessie Wells dropped a John. Prine style protest song less than a. week after the killing with lyrics that. took aim at United Healthcare. >> [music]. [singing].

[music]. >> Of course, many followers of the case. also commented on Mangione's looks. They talked about the clothes he wore to. court and the music he reportedly. listens to in jail. Some even cheered his mugshot projected. on a big screen during a dance party in. Boston. There were Mangione look-alike contests. in Washington Square Park in New York. and on college campuses in Florida and. Texas. Luigi the musical reportedly performed.

to small sold-out theaters. >> But my back gave out [music and singing]. and doctors couldn't help me as dollar. signs decided [music] who would live and. who would not. >> [singing]. >> Mangione merchandise went up for sale. online. T-shirts, votive candles, Christmas ornaments, pint glasses, wine. tumblers, and baseball caps. Some. featured Mangione's face. Others said. free Luigi or deny, delay, depose, the. words that police say were etched into.

the bullet casings found at the crime. scene. After Mangione was charged with Brian. Thompson's murder, online fundraising. for his legal defense surpassed more. than 1.5 million dollars. >> [music]. >> GiveSendGo, the platform that hosts. Luigi Mangione's legal defense. fundraiser, confirmed to ABC News that. the fundraiser is still active and said. that there was renewed interest in. donating [music] to the fund after. Mangione pleaded guilty in federal. court. Some donors posted comments like, "Guilty, but not wrong." And, "Luigi.

[music] is morally innocent.". Luigi-mania reached Mangione's jail. cell, too. He started receiving mail at. the [music] detention center. As of last summer, it was 10 to 115. letters per day, according to his. [music] attorneys. And this became more than an online. phenomenon. It was impossible to attend. one of Mangione's hearings without. seeing his supporters outside or inside. [music] the courthouse. So, what's motivating Mangione's.

supporters? And what do you think of the latest. development when he stood there in court. and admitted to this crime, pleading. guilty in federal court? What now? Months ago, before he pleaded guilty in. federal court, a few supporters of Luigi. Mangione agreed to an interview with us. under the condition that we only use. their first name for fear of losing. their job or harassment for their. support.

>> The main reason why I cared was because. it seemed like the focus was corruption. in healthcare and health insurance, and. that was something that I care about. >> That's Stephanie. She's a 26-year-old. nurse based in Connecticut. As a critical care nurse, Stephanie. treats people with immediate, often. life-threatening medical issues. She. says she's also seen the high bills and. claims denials that patients often face. after seeking urgent care. She was already familiar with hospitals.

before her job. When she was a kid, she. said she watched her mom go through. years of treatment for stage four. cancer. Years, she says, of watching her mom. fight the sickness while also working to. afford the treatment. >> So, imagine that. I mean, you're given a. prognosis of 3 months, and then, which. thankfully was uh pushed to 5 years by. the end, but she was working full-time, 40 hours a week, as a single parent to. afford her health insurance so that she.

could continue to get chemo and whatever. other care she needed to treat her. terminal illness. >> From the moment she heard about the. shooting, before anyone was arrested, Stephanie says she believed it was done. to send a message. >> I thought maybe, you know, maybe killing. somebody is not necessarily what we need. to do, but I liked that somebody took it. upon themselves and risked everything. to make a statement. I felt like [music].

something is going to come up this, you. know? >> So, Stephanie decided she wanted to show. her support. She started a pro-Mangione account on a. few social media platforms, and it. quickly grew a following. She's shared tweets making fun of the. New York City perp walk on that dock in. the East River, and stylized edited. videos of Mangione in court. But, she. says she prefers to focus on fundraising. efforts and legal updates. She acknowledges that the Mangione posts.

that blow up are often the ones focused. on his looks, but she says she tries to. stay away from those. >> I mean, I I think it would be silly to. pretend that he's not good-looking, you. know? To to pretend that that has. nothing to do with anything would also. be ridiculous, but [music]. the true supporters are not here for. looks, and it's a pretty ridiculous. thing to suggest [music] after over a. year of this. >> Stephanie feels like people have been. quick to dismiss Luigi's supporters as. some kind of fangirls.

She says it's one reason why many of. them are hesitant to speak to the press. >> You see headlines about. uh I don't know, let me just throw any. random number, 30 young women in line. for 20 hours to see sexy killer, like. things like that. And uh I mean, wow, like how demeaning. And it's the fact that it's it's not. just young women or women in general. I. mean, if you go to a hearing, there's. people from all walks of life,

all genders, all ages. >> Stephanie told us that Mangione's guilty. plea in federal court has strengthened. her support for him. >> [music]. >> Having confirmation that he did what he. was accused of and clear insight into. the motive has brought a real sense of. relief because now the supporters are. free to stand behind him and his cause. I'll keep supporting Luigi through every. stage of his legal battles and as a. person, no matter how everything plays. out.

>> [music]. >> My support has not changed at all. >> That's Jamie, a public school educator. in her 50s. She has a husband and an adult son. Jamie said she donated to Mangione's. legal defense fund and has helped. supporters leading efforts in New York. City. She also said she's written to Mangione. Jamie said she's been passionate about. healthcare reform for a while now, but. for her, this story started out much. more personal. In June 2024, months before she would.

ever hear the name Luigi Mangione, Jamie. decided to schedule an MRI. Breast cancer runs in her family and it. had been on her mind. She says she has good insurance through. her job and she believed it would cover. the MRI. So, she arrived at her appointment and. started filling out the typical. paperwork. >> [music]. >> She was nervous. She was thinking about. the different outcomes, the worst-case. scenarios. But before she was taken to the MRI, >> they asked me for $1,800.

And that was the first time [music] I. had been told that. it wasn't covered or that I would have. any portion to pay. >> Jamie says she started panicking. She. ran into the lobby and called her. insurance company. She said they were. just as confused as she was. >> It should be covered. I said, "Well, should is a great word, but I I they're asking me for $1,800. right now and I have about 10 minutes to.

figure this out. >> According to Jamie, they did not figure. it out. Jamie left the appointment. without getting the MRI. The bill was unexpected and way too high. for her. She remembers leaving, getting home, and. bursting into tears. >> I. I didn't put myself first. And I think as women we sometimes do. that, as moms especially. And I just remember this overwhelming. feeling of I've got to figure this out.

>> Jamie says she still wanted an MRI. >> So a year went by and my annual exam. came up again and I asked my. doctor again. But the difference this time was that it. was the summer of 2025. And I had spent 6 months. >> [music]. >> at that point. following this story. >> [music]. >> And.

really learning what it means to fight. for myself. by watching somebody fight for himself. So ultimately. I was inspired [music] by Luigi to fight. for myself. and advocate with my insurance company. >> Jamie says it wasn't what Mangione was. at that [music] point accused of that. she was inspired by. Instead, she says [music] she was. inspired by what she learned about him.

outside of the allegations. What she read of his reported Reddit. account, with descriptions of his back. problems, and comments advocating for. others who struggled with similar. issues, and what she saw following the. case from home. Mangione in court fighting the charges. >> He held his head high. He. clearly was. wanting to fight these charges. and did so.

with as much dignity as he could. >> Jamie thought she needed to fight harder. for herself, for her health. She needed. to be her own advocate and try harder. for an MRI. Jamie felt pushed to research her health. care coverage and made calls, hours. worth of calls, she says, trying to get. her procedure covered. Jamie says her insurance provider was. extremely helpful in the process, and. the provider discovered a coding error. that caused the unexpected bill. The MRI was supposed to be covered. Her.

insurance helps her book a new. appointment. In summer 2025, a full year after that. first MRI, the one she'd walked away from, Jamie finally had a fully covered MRI. >> I had had a mammogram. about 3 weeks prior that was clear, so I. didn't have any reason to believe. that the MRI would show anything. Um.

but it did. And. I was diagnosed. with breast cancer in August of 2025. And. >> [music]. >> at first I was really angry. >> [snorts]. >> for all the the normal reasons that you. would be angry when you get diagnosed. with cancer. >> Looking back now, Jamie's at peace with. the way things worked out. They caught it in time, and she's now. cancer-free.

>> This person came into the universe and. became a public figure. at the right time for me. And so for that, I um. I'm very, very grateful to him. >> Jamie says it was tough learning about. Mangione's guilty plea in federal court. >> I never doubted. that. when he played not guilty, it was.

to try to get the most advantageous. result, not because he was actually not guilty. And it's different to know that and to. hear him admit it. And I kept having to tell myself that. this was a choice he made. That he didn't find himself in these. circumstances. accidentally. The idea that he might serve.

>> [snorts]. >> the rest of his life in prison is is a. hard thing to. accept, but. I think. we have to know, at least for me, that. this was that important to him. And that's where we all. have to do our part. to make sure that people get the care. that they deserve.

>> We asked AHIP, a national trade. association that represents the health. insurance industry, about patients who. experienced delays in treatment because. of insurance coverage. A spokesperson wrote that they recognize. that patients are understandably. frustrated when treatments or procedures. are not approved as quickly as expected. and pointed to providers' reliance on. outdated manual processes as a source of. delays. They also said that health plans are. working to improve the consumer. experience.

We also asked AHIP about the stories. people shared after Brian Thompson's. murder, about their frustrations with the health. care industry. They said most Americans rate their. health plans positively. and that we agree that much more needs. to be done to reduce costs and create a. simpler, more seamless experience for. patients. Jamie remembers when she first heard. about Brian Thompson's murder and what. Mangione was accused of. She said she felt awful for Brian and.

his family. >> Obviously, murder it was awful and so all of those. thoughts are kind of going through my. head. I remember thinking, you know, obviously that I I felt. terribly for this person. as a as a person, but. the public at large really understood. We we kind of felt like we understood. why this happened. I wouldn't say I was ever in the camp of.

deserve is is such a strong word that. that doesn't feel like how I ever felt. Um, but understand. why. I think that's where I landed. >> When Mangione pleaded guilty to two. counts of stalking federal court, he. brought up health care. He said during the plea hearing that he. undertook his plan to stalk and shoot. Brian Thompson after enduring severe. pain from a broken back and obstacles.

from the health insurance system. Mangione's alleged writings also include. criticism of the US health care system. If Mangione's state case does go to. trial, health care will likely come up. again. So what about the system is being. criticized in these alleged writings? And what do people who know the ins and. outs of the health care system make of. that criticism? >> [music].

>> In the letter to the fans, which. authorities allege was written by. Mangione, the writer claims that greed. fuels the American healthcare industry. and says, "I do not pretend to be the. most qualified person to lay out the. full argument, but many have illuminated. the corruption and greed." The writer. then cites two names in parentheses, Rosenthal, {comma} Moore. Prosecutors say the Moore in parentheses.

is Michael Moore, the famous filmmaker. who made the 2007 film Sicko, exploring. his views on the crisis of healthcare in. America. And the Rosenthal, according to. prosecutors, is long-time health. reporter Dr. Elizabeth Rosenthal. She wrote An American Sickness, a book. that argues that America's for-profit. medical system exploits vulnerable and. sick patients. When Dr. Elizabeth Rosenthal learned her. work was cited in the letter to the. fans, she could have easily found the.

letter and read it in one of the several. places it was published and quoted. online. But she didn't. >> I didn't really. feel comfortable being connected with. a murder. I was not in a place to. read it. >> At the time, Dr. Rosenthal was in a. hospital waiting room where her husband. was getting chemotherapy for stage four. cancer. >> He was doing really badly and he was. dying and I was.

fighting many of the kind of patient. battles that. I'd written about but hadn't. experienced. >> Dr. Rosenthal has been a reporter for. over three decades, covering healthcare. for much of that time. She's currently senior contributing. editor at KFF Health News, a newsroom that covers health topics. nationwide and conducts health policy. research and polling. Before that, she was at The New York. Times. And before her career in.

journalism, she worked as an ER doctor. at the height of the AIDS epidemic. None of that prepared Dr. Rosenthal for. her husband becoming so ill. And on top of that, having to grapple. with the news that her work was. allegedly cited by a murder suspect, as. prosecutors would eventually argue. >> It was. an awful day on so many accounts, but. you know, I. I just didn't know what to say. I got a. lot of interview requests, and I was. kind of like, I'm speechless. This is.

a terrible thing for someone to do, and. um. boy, has it come to this? I I never. imagined that. >> It's been almost 2 years since Dr. Rosenthal was in a hospital waiting. room. Almost 2 years since that letter. first appeared in the news. So, when we asked her if she'd be. comfortable reading the letter now, she. agreed. Dr. Rosenthal quietly looked over the.

letter. The criticism of this country's. healthcare system, the reference to what. prosecutors argued was herself and. Michael Moore. The claim that for-profit insurance has. amassed power and wealth, and become. greedy. When she was done, she looked up from. the paper, and simply said, >> Yeah, I mean, that's just true. It was a mix of analysis and statistics, and also just raw anger that was not. you know, not going anywhere good.

>> Though she might believe that the. statements in that letter are true, Dr. Rosenthal wants to be really clear about. something. >> Any attempt to kind of demonize one. person or another is really um. it's really wrong-headed. I mean, murdering someone is. not any kind of answer to our health. care problems.

>> Rosenthal worked as a reporter overseas, and as she encountered health care. systems abroad in Sweden and Italy, and. then returned home and saw health care. in the US, she says she saw problems. here. >> When I came back to the United States. after about a decade away, I was kind of. shocked at how much everything cost. I. mean, I I just couldn't understand it. >> Dr. Rosenthal and other experts point. out that compared to people in other.

wealthy countries, in the US, we pay. more for health care and have worse. outcomes. According to one Commonwealth Fund. report from earlier this year, Americans. have the lowest life expectancy compared. to people in other wealthy developed. nations. And health care in this country is so. expensive that around one in five. Americans carry medical debt totaling. about $220 billion. as of 2021, according to a recent JAMA. study.

And part of the cost for Americans is. claim denial. Another Commonwealth report from earlier. this year found that one in five adults. in this country, Americans who have. private insurance, say that in the past. year they or a family member had a claim. denied or care recommended by a doctor. >> For many Americans, >> [music]. >> health care has become a pocketbook. issue, right? And that's. the way they feel it is [music].

almost like their health care is. secondary. It's like, I can't afford. this [music] stuff. >> After all of these years of research and. reporting, Dr. Rosenthal has come to. believe that the root of these. debt-inducing [music] prices is. America's for-profit system. We asked AHIP, the health insurance. trade association, about this. conclusion. A spokesperson wrote, "Quote, health. plans are the only part of the health. care system focused on holding down.

costs and making [music] coverage and. care more affordable for consumers. They negotiate substantial discounts. with providers, combat fraud and abuse, promote the use of lower cost generic. medications, and help people access. preventive care without cost sharing.". They pointed to fee-for-service payment. models that reward volume rather than. value as the cause of expensive health. care and said that they strongly support. bipartisan reforms to lower health care. costs for everyone.

Dr. Rosenthal points out that there are. many entities within America's health. care system, insurance companies, hospitals and medical providers, drug. manufacturers. She says they are all. part of a system working the way it. does. >> Everyone's a bad guy. You know, and I. think that's the problem. People like to. say, "Oh, it's the insurers." Or, and. you know, the the insurers like to say, "Oh, it's the pharmacy benefit. managers." You know, I've done panels. with people from each sector, and it's.

like a circular firing squad. It it's. it's a very overwhelming problem. >> And she says it gets even more. complicated because each of these. different parts of the system can be. owned by one company, something called. vertical integration. So, Dr. Rosenthal might ask an insurance. company about a bill and. >> they'll say, "Oh, well, it's not us who. are denying this claim. It's this claims.

review processor." And I'm like, "Wait, they are you. They have a different. name, but you guys are the same company. How how can that be?". >> In some ways, Dr. Rosenthal says it's. like a twisted joke. >> But it's not funny, really. It's tragic. >> In the decades Dr. Rosenthal has been. reporting on healthcare in this country, she's seen the Clinton healthcare plan. get introduced in the [music] '90s, the. passage of Obamacare in 2010, and the. Medicare for all debates in the 2010s.

But after all that, Dr. Rosenthal says. the system is still deeply [music]. dysfunctional, and most Americans agree. A 2024 Gallup poll found that nearly 70%. of Americans see the US healthcare. system as being in a state of crisis or. having major problems. In January, Congress held hearings on. the cost of healthcare in America, >> [music]. >> and the CEOs of several major insurance. companies testified, including Stephen. Hemsley, the CEO of United Health Group.

>> [music]. >> Like all of you, we are dissatisfied. with the status quo. And not And no, we must all do better. And so we are committed to doing exactly. that. >> In his testimony, he said insurance. costs are going up because the cost of. healthcare itself has been rising. >> Hospital and drug spending has soared at. three times the rate of inflation. since before 2000. We limit these pressures as much as. possible.

>> In their testimonies, the CEOs of Cigna, CVS Health, and Elevance also pointed to. the growing cost of care as the driver. of higher insurance premiums, deductibles, and the affordability. crisis. Throughout the hearing, the committee. members asked the CEOs about many of the. same criticisms that Dr. Rosenthal and. others bring up. Like the fact that in the US, compared. to other wealthy countries, we spend. more in healthcare but have worse. outcomes.

>> I love American exceptionalism, but why. are we exceptional in this Why have so. many other first-world countries figured. out how to do this and we have not? We have a system that drives uh volume. over value and outcomes, and we have a. system that uh. drives uh. very strong pricing. >> The CEOs were also asked several times. about their company owning a health. insurance division, as well as a. pharmacy benefit manager and medical.

clinics, the kind of vertical. integration Dr. Rosenthal mentioned. >> So, Mr. Helmsley, when United owns the. insurer, the doctors, the pharmacy. benefit managers, and the care delivery. system end to end, where exactly is the. competitive pressure supposed to come. from to keep prices down? >> The. structure of that is in response to the. marketplace to actually drive more value. and drive cost down by integrating and. allowing these uh elements of uh.

healthcare services to actually serve. the consumer better. There is a great. deal of oversight and regulation on the. uh establishment of pricing uh within uh. an organization like ours. >> They were asked about patients'. frustrations with claim denials, too. >> Why. do your patients. >> [music]. >> have to. fight your company. to get their claims covered?

>> They shouldn't have to fight. We should. make this much easier [music] and. intuitive, and we use technology for. that purpose. We have a number of. initiatives in market right now. >> And they were asked about Americans'. medical debt. >> Americans now owe $220 billion in. medical debt. $220 billion. To put it. simply, [music] the system is failing. the people it's meant to serve, and that. is the patients. Mr. Joyner, in 2024, CVS Health spent a staggering [music]. $41 million in compensation to you and.

your colleague Karen Lynch. >> [music]. >> This is enough to cover the premiums for. thousands of American families. How do. you justify. getting paid that much when so many of. your patients struggle to afford. skyrocketing premiums? >> Um that was not my compensation um that. you referenced. Um this past year um my. compensation was 17 million. >> It was 17 million. >> Of which 1.1 of [music] which 1.1 was my.

base salary and the rest is long-term. incentives and the bonus based off the. performance of the year. I did return my. bonus back to the employee relief fund. Um so the employees that were going. through challenging and difficult times. got the benefit of my bonus last year. >> CVS employees? >> Yes, sir. >> This hearing happened about a year after. Brian Thompson's murder. And in the immediate aftermath of his. death, there were conversations about. healthcare. The United Health Group CEO at the time. wrote an op-ed in the New York Times.

and said the health system doesn't work. as well as it should, and no one. designed the system this way. But in the hearing, Brian Thompson came. up just once. Hemsley was asked to state into the. congressional record what kind of man he. was. >> Brian Thompson was a force for good. He was. uh a creative and effective um man in. terms of trying to address many of the. challenges that had been uh presented. today.

>> Ultimately, Brian Thompson's murder. hasn't led to any major legislation or. any real political gains for healthcare. reform. When we asked AHIP whether the. healthcare industry has made or plans to. make significant changes since Brian's. death, a spokesperson wrote, "There is. no place for violence in the healthcare. system.". There's a lot of uncertainty about where.

this case goes next. We know Mangione faces sentencing in his. federal case in December. But we're still waiting to find out if. he'll go to trial for murder in his. state case. So, what should we be watching for in. the coming months? What are the different ways this story. that's been with us since December 2024. could come to an end? Burden [music] of Proof: Luigi Mangione.

is a production of ABC Audio and 20/20, hosted by me, Ryan Buellmeyer. Produced by Vika Aronson and Audrey. Mostek. Our lead producer is Camille. Peterson. [music]. Edited by Tracy Samuelson. Music by Evan Viola. Mixing by Bob. Mallory. Special thanks to Katie Dendus, Sasha. Alslanian, Michelle Margolis, Tonya. Simpson, Aaron Cuturski, Josh Margolin, Peter Haralambus, Jared Kofsky, Jake.

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