A proposed California ballot initiative—informally named after Luigi Mangione, the alleged assassin of UnitedHealthcare CEO Brian Thompson—aims to bar insurers from delaying or denying doctor-recommended procedures or medications.

Why It Matters

Mangione, 26, allegedly shot and killed Thompson in New York City on December 4, 2024, and is facing federal murder charges that could carry the death penalty. He has pleaded not guilty.

He has gained significant support from some people, many of whom view his alleged actions as a stand against the health insurance industry. Supporters have publicly called for “Free Luigi” and raised more than $700,000 online for his legal defense.

Many Americans have expressed frustration with the health insurance system. In the aftermath of Thompson’s killing, the health insurance industry has been under intense scrutiny, with many calling for reforms to the system, which some executives have vowed to look at changes to the industry.

The proposed ballot initiative, inspired by Mangione’s alleged protest of the health care insurance industry, seeks to prohibit insurance companies from delaying or denying doctor-recommended treatments when serious health risks are involved.

What To Know

Retired attorney Paul Eisner filed a ballot initiative with the California attorney general’s office that states, “No insurer may delay, deny or modify any medical procedure or medication recommended by a treating or attending physician where the delay, denial or modification could result in disability, death, amputation, permanent disfigurement, loss or reduction of any bodily function.”

The proposal, which he requested be named the “Luigi Mangione Access to Health Care Act,” was received by the attorney general’s office on March 26. It is currently under review and Californians are able to give feedback and comments on the proposal over the next month.

The attorney general’s office determines the official title.

Newsweek filed a contact request form with the California attorney general’s office and reached out to Eisner via email on Sunday.

“Delay,” “deny,” and “depose” were written on the bullet casings found at Thompson’s murder scene. The words are believed to be related to and inspired by the book Delay, Deny, Defend: Why Insurance Companies Don’t Pay Claims and What You Can Do About It.

The words are associated with the health care insurance industry’s legal and administrative strategies in managing claims and disputes. They reflect a pattern where the company might deny claims, defend its decisions in legal or regulatory challenges, and depose claimants or witnesses in related litigation.

Eisner told local news station CBS 8 that he does not support Mangione’s alleged criminal actions but backs his protest of the industry, saying “I agree with what he was arguing, but I don’t support his method. What I am doing is the right way to do it.”

Eisner’s proposal also makes it a felony to employ someone who is not a physician to review a decision made by a physician.

What People Are Saying

Paul Eisner told local news station CBS 8 this week: “People are tired of carriers, of insurance companies denying them health care.” He defended the proposed title, saying “For a very simple reason: it is getting the attention it needs, because sometimes things require publicity.”

The California Association of Health Plans said in a statement: “The lawyer behind this measure is trying to use a murder and act of terrorism to market his political agenda. It is a repugnant action by anyone, but especially someone sworn to uphold the Constitution and law.”

What Happens Next?

The public comment period for the proposed ballot initiative remains open through April 25. The attorney general’s office then decides its official title and the measure would need to get 546,000 valid signatures from registered California voters in order to appear on the November 2026 ballot.

Mangione is set to appear in federal court in Manhattan on April 18 and is currently in federal custody at the Metropolitan Detention Center Brooklyn.