What do Luigi Mangione, a state senator and a pizzaiolo have in common?

This Valentine’s Day, one Sunset Park resident might be getting more mail than just about anyone else. Luigi Mangione is accused of killing Brian Thompson, an executive at UnitedHealthcare, and has been held at the Metropolitan Detention Center in Brooklyn while his case moves through court. He faces federal and state charges, including murder, and prosecutors have pursued the possibility of the death penalty.

Late last year, the Washington Post reported that he received over 6,000 letters since his incarceration. Supporters have shown up for court appearances, and an online legal defense fund has raised more than $1.4 million. The backlash Mangione’s case has drawn is not limited to his fans. Gallup reported that just 28% of Americans rate healthcare coverage in the U.S. as excellent or good. In one widely shared moment after Thompson’s killing, a social media post mourning his death drew 57,000 laughing emojis, according to CNN.

“I don’t condone violent action towards anybody, but the question needs to be: why are people so open to being supportive of the actions?” said State Sen. Gustavo Rivera, chair of the Senate Health Committee, in an interview with the Sunset Post. “It has to do with the fact that insurance companies have become the boogieman because of what they actually do on a day-to-day basis. People go broke because they get sick.”

Rivera argues that access may soon become even harder for millions if enhanced Affordable Care Act subsidies are allowed to expire, raising premiums for many people who buy plans through the marketplaces.

“The impact of having so many more people with no coverage whatsoever is gonna have an enormous impact on the system as a whole,” he said.

For years, Rivera has pushed a state-level alternative: the New York Health Act (NYHA), which would create a single-payer system in New York. Under the proposal, residents would pay for healthcare through a progressively graduated tax based on ability to pay, while premiums, deductibles, copays and networks would be eliminated. Dental, vision and hearing care would be included.

The bill has long had strong support in the Assembly, but has struggled to reach a floor vote in the Senate, despite a large bloc of cosponsors. Rivera believes the threat of federal cutbacks could change the political math. “This is the year to get it done,” he said.

The NYHA lacks support from union leadership, but has support among many members.

“If you’re not in the union you don’t get the healthcare, and that leaves millions of our neighbors and our constituents out in the cold,” said Marshall Lee Weimer, a Sunset Park resident and member of DC 37’s Local 375. Weimer is also a chapter delegate and chair of his local’s education and outreach committee.

Rebecca Harshbarger, also a Sunset Park resident and a member of DC 37’s Local 371, backs the NYHA, too. “The legislation would give unions across the state the freedom to bargain for other worker needs,” she said.

Rivera emphasizes that the bill mandates that any benefit previously negotiated for public unions prior to the NYHA will remain in place after implementation.

So why wouldn’t union leaders embrace the change? Weimer has a theory. “The problem is the unions see healthcare as a big draw for the union’s membership, so they don’t want to lose the bargaining chip,” he said.

Others argue that reform should happen nationally, not state by state. But Rivera says Albany can move now, and he is willing to have hard conversations with skeptics. “I’m convinced that this is a necessary battle and it will actually create a higher floor for everybody,” he said.

The debate is not limited to elected officials, policy advocates, or the people who show up at court. After Mangione was arrested at a McDonald’s in Altoona, Pennsylvania, the story seeped into group chats, school pickups, and casual conversations. In Sunset Park, it even reached a local pizzaiolo.

“The guy’s name was Luigi. That did a number on us,” said Giovanni Lanzo, owner of Luigi’s Pizzeria, as he ladled sauce onto dough topped with mozzarella, prepping grandma slices. “‘Are you related to him?’ No!”

Lanzo is related to a different Luigi: his father, Luigi Lanzo, who opened the pizzeria in 1973 at 21st Street and Fifth Avenue, where it still operates today. Luigi is also Giovanni’s middle name.

One Mangione supporter was photographed walking into court wearing a Luigi’s Pizzeria T-shirt. Lanzo said he doesn’t know the supporter personally, though customers have asked. “We sell a lot of shirts,” he said. “We’re a pretty well-known pizzeria.”

Lanzo has followed the news, including reports that major insurers have pledged to speed up prior authorizations for some tests and treatments over the next few years.

“That’s really sad that that’s what it took,” Lanzo said. “I’m not for killing somebody, but is that what it takes for these insurance companies to get a kick in the ass before they start to do something for us? I pay for medical coverage. It’s absurd. You gotta do this, you gotta get that test, you gotta get the paperwork to get the test but meanwhile they have no problem sucking up money from us.”

Asked about the New York Health Act, Lanzo expressed skepticism. “I don’t believe it until I see it,” he said. “I’m a New Yorker.”

And yet, supporters of the bill keep pushing. Rivera says skepticism is not a reason to stop. “I’m convinced that this is a necessary battle and it will actually create a higher floor for everybody.”

And if anyone wants to know what Mangione thinks about the New York Health Act, try sending him a letter.