The "check-in with intel" on his list definitely makes me think someone else was involved here. He was lonely, searching to make a difference in the world and becoming radicalized online. Could have been very easy for someone to pull him into doing their dirty work. Young men like him have always been manipulated and used in that way.
For what intentions though, I don't think it actually has to do with healthcare reform.
I found this take a while ago that explains how he may have gotten caught. Although, with what I mentioned above, being tin-foil hat-y, I wonder if he's also over-confident in some areas (that he's going home) because someone convinced him that everything would be alright, oh there's no way this could fail and you'd be in prison for life just trust me etc.
From personal experiences of being a survivor of child sex trafficking-- I've had to deal with many men of status like BT, (not just being forced to whore myself out, but coming along for business trips to schmooze and such) and ngl, so many of those sociopathic retard sexpest ghouls just straight up don't deserve to be alive lol. Most of them honestly. (Pls don't come after me feds, I don't have it in me to be a killer I'm just a poor traumatized venting silly girlie femcel on the internet). The amount of money they make and their status more often than not speaks to their sociopathy, not their merit or intellect. They don't care about the carnage they leave behind in the lives of those they deem "lesser," not just people who need healthcare.
Edit: in one of Luigi's note(book)s(?) I think he mentioned "healthcare ticks every box." I don't think it was
just the healthcare industry he had beef with but was a target most likely to get public support.
It's easy to say whatever about Luigi's state of mind, narcissism and whatever but 2 things can be true at once, and having been around many of these men myself, I wouldn't be surprised that Luigi 1) ended up insane enough to have a capacity for murder to begin with 2) doesn't feel any remorse. But I think while Luigi may have had good intentions to begin with, I do wonder if someone played a hand in manipulating him for selfish reasons that pushed him over the edge to murder (not unlike the tactics of any other sociopath he wanted to target, unfortunately).