Prediction market platforms such as Kalshi and Polymarket are rapidly expanding across the United States, including in states where gambling has long been illegal, but public health resources for problem gambling are failing to keep pace, experts warned. The surge comes amid endorsement from President Donald Trump, who has called for federal oversight of the industry.
Trump Endorses Prediction Markets
Trump weighed in last month, stating it is "critically important" that the Commodity Futures Trading Commission (CFTC) maintain "exclusive authority" over prediction markets rather than states. "It is a major Industry, and we must protect it," he said. The White House added in a statement: "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."
Industry Boom and State Challenges
Since the US Supreme Court struck down a federal ban on sports betting in 2018, digital gambling has boomed. Sports betting is now legal in 39 states and Washington DC. Prediction markets have risen rapidly, with platforms like Kalshi marketing aggressively around the NBA finals and Polymarket sponsoring UFC fights at the White House. These platforms argue they offer "event derivatives" regulated by the CFTC, not gambling, allowing them to operate in states like Utah and Hawaii where gambling is illegal. Over a dozen lawsuits challenge this interpretation, arguing they should fall under state gambling laws.
Public Health Resources Lag
"When you expand access and availability and normalization of it, you're going to have more participation," said Timothy Fong, an addiction psychiatrist at UCLA. "When you have more participation and engagement in risky products, you're going to have more problems." Fong noted that resources for problem gambling are "phenomenally way way behind." In California, the state spends about $9 million annually on problem gambling, compared to hundreds of millions for tobacco and alcohol harm.
"The larger question has always been, who's responsible for help?" Fong said. There is no dedicated federal funding for gambling addiction prevention or treatment. In Utah, which has strong anti-gambling laws, no federal or state-funded resources exist for problem gambling. Despite opposition from Republican leaders, prediction markets operate there with presidential support.
Helpline Calls Surge
The National Council on Problem Gambling (NCPG) helpline has received nearly 18,000 calls from Utah residents since 2016. In May 2025 alone, it recorded 319 calls from Utah, the highest monthly total since 2017. Fong said the actual number suffering is likely larger, as many "just suffer quietly."
Cole Wogoman, NCPG's director of government relations, said the helpline can "only offer resources if the resources are there." In Utah, callers may receive budgeting guidance and information about peer-support groups, but little else. Gamblers Anonymous has only one in-person meeting in Utah, though virtual meetings have expanded access.
Federal Funding Push
A recent NCPG survey found 45% of Americans believe prediction markets are comparable to gambling, and 85% believe users can develop addictive behavior. 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 the federal government takes this addiction seriously," said Wogoman.
Elliott Rapaport, CEO of Birches Health, which offers online therapy for gambling addiction, said any activity combining "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.
