Betting platforms are reaching into every corner of American life, from sports arenas to living rooms, but the mental health infrastructure to treat gambling addiction is nowhere close to keeping pace. Kalshi and Polymarket have muscled their way into mainstream consciousness with aggressive marketing at major sporting events, yet they operate in a regulatory gray zone that leaves vulnerable people exposed.
The platforms argue they are not gambling operators at all, but rather "event derivatives" overseen by federal regulators. That legal distinction has allowed them to operate across the country, including in states like Utah and Hawaii where traditional gambling remains prohibited. Trump's administration has backed this interpretation, with the president himself declaring it "critically important" that federal authorities maintain exclusive control over these markets rather than states.
But addiction specialists are alarmed. Timothy Fong, an addiction psychiatrist at UCLA who studies gambling behavior, warns that expanding access inevitably creates more problems. "When you expand access and availability and normalization of it, you're going to have more participation," Fong said. "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."
The funding disparity is staggering. California, for example, dedicates about $9 million annually to addressing problem gambling through its Department of Health, while spending hundreds of millions on tobacco and alcohol-related harms. Nationwide, there is no dedicated federal funding stream for gambling addiction prevention or treatment at all.
In Utah, which maintains some of the nation's strictest anti-gambling laws, there are zero federal or state resources designated for problem gambling treatment. Yet the National Council on Problem Gambling's helpline, which relies on donations, fielded 319 calls from Utah residents in May 2025 alone. That was its highest monthly total since 2017. The organization has recorded nearly 18,000 calls from the state since 2016.
When Utah residents do call for help, the nonprofit can offer little beyond budgeting advice, peer support group information, and telehealth counseling that often requires health insurance. Gamblers Anonymous operates just one in-person meeting in the entire state, though virtual sessions have expanded somewhat since the pandemic.
Cole Wogoman, director of government relations for the National Council on Problem Gambling, acknowledged the constraints bluntly. "We can only offer resources if the resources are there in relevant states," he said.
The human toll remains largely invisible. Many people struggling with compulsive betting never call a helpline or search the internet. They simply suffer in silence. Fong estimates the real number of people experiencing harm from gambling is substantially larger than official tallies suggest.
Public perception suggests the problem is serious. A recent survey found 85% of Americans believe users can develop unhealthy or addictive behavior related to prediction markets. Forty-five percent consider them comparable to gambling, while 27% view them as similar to investing.
Elliott Rapaport, founder of Birches Health, which provides online therapy for gambling addiction recovery nationwide, said his company has seen increased outreach from people in states where gambling is illegal. "You don't have the state safety net, and the state access to care there," he explained. "When you combine money, uncertainty and risk, it can lead to compulsive behaviors for some users."
States with legal gambling have found one solution: funding treatment through tax revenue from casinos and sportsbooks. But states without legalized gambling could still allocate resources through their general budgets. So far, few have.
Congress has begun to respond. The Points Act, introduced in March, would establish the first federal funding stream dedicated to gambling addiction prevention and treatment. The National Council on Problem Gambling has backed the measure. "It's long past due that the federal government takes this addiction seriously," Wogoman said.
Author James Rodriguez: "The same administration cheerleading prediction markets as innovation should be funding the treatment infrastructure to handle the casualties, not leaving it to overwhelmed nonprofits surviving on donations."
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