Marching Toward Gambling Madness (Pt. 1)

It’s time to fill your bracket and brush up on your ball-knowledge: March Madness is here. The iconic college basketball tournament has been a staple of the sports calendar for nearly a century, but the stakes of this year’s tournament are higher than ever before. That’s because viewers are expected to bet more than $3.1 billion on the results this year. This is a stunning number by any measure, especially considering that sports gambling was banned throughout most of the country until just a few years ago.

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This is Part 1 of a two-part series for the Bill of Health Blog regarding the dangers of the sports gambling industry. Below, I will describe how popular will—in conjunction with a 2018 Supreme Court decision—paved the way for the industry’s meteoric rise. In Part 2 I will describe the addictive nature of gambling and discuss possible legal remedies.

Sports Gambling and Consumer Choice

If you had asked me a year ago if my Indiana Hoosiers would make March Madness, I would have told you “without a doubt.” The betting odds were in my favor, but of course, they missed the tournament. My fandom bias often leads to misjudgment, one reason I rarely place bets on my sports predictions. Though when I get lucky enough to win a bet, I am reminded why most of my friends love sports gambling: Winning is fun. Not to mention, it helps out our state by generating billions in state tax revenue every year. No wonder the legalization of sports betting has had such widespread consumer—and voter—support.

Casinos, state governments, and most users themselves benefit from an economy with state-permitted sports betting. But when so many parties profit, it can be easy to ignore the smaller group of people the industry harms. The policymakers who paved the way for the industry’s rise should take a closer look into how mobile sportsbook apps pose a unique threat to the physical, psychological, and financial health of millions of Americans.

Sports betting history in the U.S.

Recognizing that sports gambling was a “national problem,” Congress passed the Professional and Amateur Sports Protection Act (PAPSA) in 1992. The bill banned states from permitting the activity, but granted a carve-out to Nevada, which had already authorized sports gambling. Thereafter, sportsbooks (establishments that take bets on sporting events and pay out winnings) only operated out of casinos in Las Vegas and select tribal-owned lands. This made forming a propensity for sports gambling rather inconvenient; a taboo luxury more than a daily habit. The setup preserved the sports gambling industry as an incredibly profitable business enterprise, but its profits were not evenly distributed. They were concentrated into the hands of a select few casino owners. Nevada had been the only state to pass a bill authorizing sports gambling before the federal government banned the activity, meaning it was the only state which could collect tax revenue from sports bets.

In 2018, everything changed. That year, the Supreme Court ruled in Murphy v. NCAA that PAPSA was unconstitutional. The case arose following a referendum in the state of New Jersey, where residents overwhelmingly voted in support of amending the state constitution to authorize sports gambling. In a 6-3 ruling, the Court held that the federal government, through PAPSA, could not override the popular vote of New Jersey residents—an application of the so-called “anti-commandeering” rule. The decision opened the door for the plaintiff state of New Jersey, and any other state, to begin allowing sports gambling. In due course, referendums to legalize sports betting popped up in state after state across the country. It was a slam dunk; voters overwhelmingly supported the referendums and cash-strapped state governments secured a new opportunity to generate tax revenue.

Today, some form of sports gambling is legal in 38 states (plus Washington, D.C.). Americans wagered nearly $150 million on sports in 2024, a more than 1,000 percent increase from 2019. The industry collectively raked in approximately $14 billion in revenue, generating $1.8 billion in state tax revenue.

Consumer choice

Supporters of the sportsbook industry often tout lofty ideals such as “consumer choice,” personal responsibility, and individual freedom when pushing for further legalization. They argue that consumers, as responsible adults, ought to be able to spend their money how they wish – without the government looking over their shoulder. One West Virginia state senator embraced this argument, stating, “If somebody decides that they’d rather spend $50 on the outcome of an NFL game as opposed to going out to the movies, I think they should have the right to do that.”

The problem, however, is that sports gambling is not simply another common form of entertainment. Sports gambling is a highly addictive activity which, in its modern form, preys on the brain’s reward system and capitalizes on impulsivity. A trip to the movie theatre, as wonderful as it is, does not offer the same prospect of return on investment. It is rarely the source of financial ruin, nor a trigger for compulsive behavior. As I will outline in part 2 of this series, the psychology of gambling complicates any argument in favor of “consumer choice,” because in regards to sports betting, placing a bet is not always a free choice.

Part 2 of this series is here.

About the author

Spencer Andrews (J.D. 2026) is a student fellow with Petrie-Flom Center. He hails from small-town Indiana and worked for three years as a research fellow at the National Institutes of Health (NIH) before attending law school. His background in neuroscience inspired him to dig deeper into the societal impacts of addiction and mental illness in the U.S.