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Luigi Mangione, the Ivy League-educated data engineer, has pleaded guilty in New York to federal charges over the killing of UnitedHealthcare chief executive Brian Thompson.
The University of Pennsylvania alumnus, 28, faces the possibility of spending the rest of his life in prison after he admitted responsibility for shooting the multi-millionaire in 2024.
The 50-year-old was shot in the back as he left his hotel in New York City on December 4, 2024.
Sparking a nationwide manhunt for Mr Thompson's killer, the then-26-year-old Mangione was arrested in Altoona, Pennsylvania five days later.
In the courtroom, Mangione, dressed in a beige jail uniform was asked by the judge to detail what he did which makes him guilty.
He proceeded to give a detailed account of what led to the shooting that day.
Mangione said: "I shot Mr. Thompson... and he died."
Members of the Thompson family began crying as the 28-year-old spoke, admitting to killing the healthcare boss, CBS reports.
Mangione attending a pre-trial appearance at Manhattan Criminal Court on Tuesday
|REUTERS
Judge Garnett put a series of questions to Mangione to confirm he was pleading guilty because he was in fact guilty, and to establish that he understood what the plea meant.
Mangione responded to each with a simple "yes" or "no."
His lawyer confirmed no plea deal had been reached with the federal government.
Mangione then read a prepared statement to the court, in which he admitted to planning the attack on Brian Thompson in advance, crossing state lines with the intention of killing him, and 3D-printing components of a firearm, which he later fitted with a silencer and magazine.
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Paulette Thompson, wife of late Brian Thompson, walks outside Manhattan Criminal Court today
|REUTERS
He also told the court he had emailed UnitedHealthcare ahead of an investors event Mr Thompson was due to attend, posing as an investor to ask questions about the event.
He noted that, unlike previous exchanges with the company, this email received an immediate response.
"On the morning of 4 December 2024," Mangione said, "I shot Mr Thompson in Manhattan and he died." He later added: "I knew it was illegal."
His guilty plea is for federal charges, whereas Mangione still faces right New York State charges, including second degree murder.
In the state case, he pleaded not guilty on all eight counts, triggering a trial which is due to start on September 8.
There is a possibility Mangione's defence lawyers could argue he faces double jeopardy - the US constitution protects its citizens from being prosecuted for a crime twice.
Mangione's defence lawyer, Karen Friedman Agnifilo, said his legal team has filed a motion in state court arguing that the state charges against him "must be dismissed under New York's double jeopardy protections".
She added: "New York law does not permit a person to be prosecuted and punished twice for the exact same crime."
Friedman Agnifilo also said that, by entering a guilty plea in federal court, Mangione had accepted "full responsibility" for Brian Thompson's death.
She said Mangione had endured "years of severe debilitating pain while struggling to navigate healthcare and insurance systems," and believed the system had "failed him and destroyed his life".
Speaking outside the courthouse, James McDonald, US District Attorney for the Southern District of New York, said because Mangione entered his guilty plea without a plea deal, prosecutors remain free to "seek the maximum penalty under the law".
He added: "There are no accommodations or concessions."
A maximum sentence could see Mangione jailed for life.