How Luigi Mangione sparked a mother’s relentless crusade for health care reform

Luigi Mangione, the 26-year-old accused of fatally shooting UnitedHealthcare CEO Brian Thompson, is continuing his battle against the health care industry from behind bars. In a series of emotional letters, Mangione has connected with supporters, including a mother named Karen, whose personal struggles with the health care system have deeply resonated with him.

Karen’s struggles with UnitedHealthcare spark connection

Karen, who is fighting to afford her daughter’s medical care, wrote to Mangione after seeing his perp walk in December. The letter was shared by Ashley Shelby on her Substack, Bartleby on Trial, which covers Mangione’s case.

Driven by an unexplainable force, she felt compelled to reach out. In her letter, Karen recounted her difficult experiences with UnitedHealthcare, alleging the insurer denied coverage for her daughter’s life-threatening condition, even after she was hospitalised for 60 days in 2024. She described the situation as a result of insurance companies making medical decisions rather than doctors, and condemned UnitedHealthcare as “white-collar criminals.” Karen pledged to fight for health care reform in her daughter’s name for the rest of her life.

“What she and I went through as a result of insurance calling the shots rather than the doctors is a horrible story for another time. She is improving, but hardly close to her old self. I refer to UHC as ‘those white collar criminals’ whenever discussing them and vowed to fight for reform for the rest of my life,” Karen told Shelby.

Mangione's response to Karen

“Your letter is the first to make me tear up. I am so, so sorry for what you and your daughter so senselessly had to endure,” Mangione wrote in response to the anonymous mother, identified only as Karen. He agreed to keep a photograph of Karen and her daughter, along with a print of Jesus she referenced, on his prison cell wall.

“Your daughter is blessed to have a mother who loves her so much and fights for her so relentlessly,” Mangione added.

Karen’s letter is just one of many Mangione has received since his arrest in December. In a recent public statement, Mangione expressed gratitude for the support he has garnered, stating, “I am overwhelmed by – and grateful for – everyone who has written me to share their stories and express their support. While I can’t reply to most letters, please know that I read every one that I receive.”

Mangione’s growing support and gratitude for letters

Mangione is currently being held at Brooklyn’s Metropolitan Detention Center on first-degree murder charges, in addition to federal terrorism charges. Prosecutors allege that the shooting of Thompson was a symbolic attack on the health care system, which Mangione had described in his manifesto as "parasitic." Despite the charges, Mangione has pleaded not guilty, and his case continues to draw national attention.