Every major public health challenge eventually reaches a point when evidence becomes difficult to ignore. Pennsylvania may now be at that point with gambling.
A newly released landmark report, “Sports Betting and Related Interactive Gambling in Pennsylvania,” commissioned through House Resolution 60, represents one of the most comprehensive examinations to date of gambling-related harm in the state.
The report reviewed problem gambling behaviors, impacts on mental health, effects on college athletes, youth exposure to gambling advertising, and the inadequacy of current guardrails.
Most importantly, it provides lawmakers with clear recommendations for next steps.
Consequences of Gambling Expansion
For years, gambling expansion in Pennsylvania has centered around tax revenue. The Commission’s 126-page report shifts the conversation toward the human impacts.
Until now, Pennsylvania has created harm and then patted itself on the back. It has pointed to individual responsibility.
Since Pennsylvania legalized online gambling in 2017, the Commonwealth has become the largest online gambling market in the U.S. Pennsylvania generated approximately $7 billion in gambling revenue in fiscal year 2025/2026, with growth outpacing that of many other states.
At the same time, evidence of gambling-related harm has mounted, including rising gambling helpline use, growing numbers of individuals enrolling in self-exclusion programs, and surveys about financial distress, family disruption, harassment of student athletes, and suicide risk.
What Experts Say
The report reflects what addiction specialists, psychiatrists, and public health experts have been warning for years.
The Pennsylvania Psychiatric Society supports the policy recommendations to prohibit the use of credit cards for gambling, establish player limits, eliminate autoplay features, curb youth exposure to advertising, restrict prop bets and micro-betting, and curtail or eliminate VIP programs.
These findings represent an important step toward reducing gambling-related harm. Lawmakers routinely regulate products and industries when evidence demonstrates harm.
Tobacco, opioids, alcohol, and motor vehicle safety provide historical examples of policy interventions that initially faced resistance but ultimately protected public health.
Gambling should be treated no differently.
Why This Moment Matters
The significance of the Pennsylvania gambling report extends beyond the specific recommendations listed in its pages.
For the first time, a bipartisan legislative research body has documented the public health implications of Pennsylvania’s gambling environment and presented evidence-based options for reform.
The Commonwealth now faces a defining moment.
Will Pennsylvania continue expanding gambling while relying primarily on individual responsibility, or will lawmakers adopt evidence-based protections that prioritize public safety?
Kavita Fischer, MD, is a board-certified child, adolescent, and adult psychiatrist based in Pittsburgh, Penn. She is the president of the Pennsylvania Psychiatric Society and a national advocate on gambling-related harm.
