Luigi Mangione wore handcuffs when he leaned over the microphone in the Manhattan court to announce his stance on the allegations. The Manhattan District Attorney formally charged him last week for multiple counts of murder, including terrorist crimes.
His first appearance in the New York state court comes after federal prosecutors brought federal charges. The sentence carries the death penalty, while the maximum sentence for the state charges is life imprisonment without the possibility of parole.
According to the authorities, Mangione shot United Health's CEO Brian Thompson when he was on his way to an investor conference on Manhattan on the morning of December 4.
Mangione was arrested at a McDonald's in Pennsylvania after a five-day search and was carrying a pistol that matched the one used in the shooting and a fake ID, according to the police.
He was carrying a notebook that expressed hostility towards the health insurance industry and specifically towards the rich CEOs who profited from people's suffering, according to Mangione.