Prediction Markets Expand Rapidly Across the US
Prediction market platforms like Kalshi and Polymarket have surged across the United States, allowing users to wager on events from Tony Awards to World Cup goals. These platforms are heavily advertising in states that have long prohibited gambling, raising concerns among public health advocates about the lack of resources for problem gamblers.
Donald Trump has endorsed the industry, calling for the Commodity Futures Trading Commission (CFTC) to maintain exclusive authority over prediction markets, preventing states from regulating them. This has led to a contentious legal battle, with over a dozen lawsuits challenging the classification of prediction markets as event derivatives rather than gambling.
Public Health Resources Lag Behind Industry Growth
Timothy Fong, an addiction psychiatrist and gambling researcher at UCLA, warned that expanding access to gambling products leads to more problems. “When you expand access and availability and normalization of it, you’re going to have more participation. When you have more participation and engagement in risky products, you’re going to have more problems, you’re going to have more side effects,” he said.
Since the US Supreme Court struck down the federal ban on sports betting in 2018, the digital gambling industry has boomed. Sports betting is now legal in 39 states and Washington DC. Prediction markets have grown rapidly, with companies arguing they are not gambling but event derivatives regulated federally, not by states.
State Legal Battles and Federal Stance
Trump’s administration has been sympathetic to the industry. In a statement, the White House said: “Through executive actions, supporting legislation like the GENIUS Act, and other common-sense policies, the administration is fulfilling the President’s promise to make the United States the crypto capital of the world by driving innovation and economic opportunity for all Americans.”
A CFTC spokesperson said: “Through the Commodity Exchange Act, Congress gave exclusive jurisdiction to the CFTC for regulating swaps, including prediction markets, to ensure a federal framework and prevent a patchwork of conflicting state laws. The CFTC will defend that jurisdiction against overzealous states that attempt to bypass federal law.”
Limited Resources for Problem Gambling
There is no dedicated federal funding for gambling addiction prevention or treatment. In states where gambling remains illegal, public funding is often nonexistent. For example, Utah has no federal or state-funded resources for problem gambling, despite prediction markets operating there with presidential support.
The National Council on Problem Gambling’s (NCPG) helpline received nearly 18,000 calls from Utah residents since 2016. In May 2025 alone, it recorded 319 calls from Utah, its highest monthly total since 2017. Fong noted that the actual number of people suffering is likely larger, as many “never pick up the phone, never do a Google search. They just endure. They just suffer quietly.”
Cole Wogoman, NCPG’s director of government relations and league partnerships, said the helpline can “only offer resources if the resources are there” in relevant states. In Utah, they may offer budgeting guidance, peer-support groups, and telehealth counseling, but little else. Gamblers Anonymous only has one in-person meeting in Utah.
Industry Defends Itself Amid Concerns
Elliott Rapaport, founder and CEO of Birches Health, which offers online therapy for gambling addiction, said any activity that “combines money, uncertainty and risk” can lead to compulsive behaviors. “It’s very important to have the state social infrastructure, because otherwise people end up getting hurt,” he added.
Rapaport noted that Birches has seen increased outreach from people in states where gambling is not technically legal, because there is no state safety net. He urged lawmakers to realize that their constituents “are gambling, they’re sports betting, they’re engaging in at risky, compulsive trading behaviors, no matter whether or not these are things are legal.”
Calls for Federal Action
The NCPG has backed the Points Act, introduced in Congress in March, which would create the first federal funding stream for gambling addiction prevention and treatment. “It’s long past due to the federal government takes this addiction seriously,” said Wogoman.
