Criticism is being leveled at lawmakers in Delaware and West Virginia after a report suggests its failings in protecting its citizens from the harms of gambling addiction.
According to a report by the Center for Addiction Science, Policy, and Research, a nonprofit working to reduce addiction through science-based solutions, the states did little to curb the constant access to online betting, a dearth in addiction and bankruptcy prevention protections and a failure to enforce loss limits.
Report ranks states on gambling addiction prevention
The two states bring up the rear in a report that lists the states in letter grade order, with Delaware and West Virginia receiving an F-.
Delaware received its failing grade due to weak consumer protections despite widespread access to online betting. According to the report, the state allows 24/7 sports gambling and online casino apps but lacks key safeguards such as addiction or bankruptcy prevention measures. Additionally, gambling operators are still permitted to offer bets to individuals who show signs of addictive gambling behavior, raising concerns about protections for vulnerable users.
West Virginia scored poorly because it lacks nearly all major consumer safeguards for online gambling. The state has no mandatory loss limits, no restrictions on promotional inducements, and no ban on in-game or microbet wagering. Like Delaware, it also does not require operator intervention for high-risk users or basic protections like deposit limits, advertising restrictions, or transparency on gambling harms.
Pennsylvania, Michigan, Rhode Island, New Jersey, and Connecticut join them at the bottom of the letter grade ranking, with each of them getting “F-” scores.
Nicholas Reville, executive director of the center, said states that have legalized online sports betting have not implemented sufficient safeguards to protect people using betting apps.
In a statement, he said: ““If you’re serving someone alcohol and they show signs of intoxication, it becomes illegal to keep serving them,” Reville said. “But states are allowing online gambling companies to continue serving online bets when someone is clearly showing traits of problem gambling.”
Massachusetts ranks highest of states that allow legal gambling
The highest scoring state out of those that have legalized online gambling is Massachusetts, which got a D letter grade.
The report gained positive notes for issuing a ban on using credit cards to fund betting accounts, support for problem gambling resources and messaging, and a self-exclusion list for users seeking to block themselves from gambling platforms.
Massachusetts also scored higher after taking legal action against prediction market platforms offering sports-related event contracts. State regulators moved to block the offerings, arguing they function like unregulated sports betting. The report credited the action as a step toward closing the “investment contract” loophole that has allowed some platforms to market sports wagers as financial derivatives.
Gambling survey reveals most US adults gambled before 21
The latest report comes after a national survey by The Harris Poll for the National Council on Problem Gambling found early exposure to gambling is common in the United States, while discussions about gambling in healthcare settings remain rare. The February 2026 survey of 2,072 adults found that 65% of respondents aged 21 and older said they gambled before reaching the legal gambling age of 21.
Among those who gambled before 21, 40% said they played lottery or scratch-off tickets and 37% participated in home games for money with friends or family. Others reported sports betting (23%), online casino-style games (21%) and fantasy sports (16%). Younger adults reported higher rates of underage sports betting than older generations.
Public concern about youth exposure to gambling was also widespread. Sixty-six percent of respondents said they were concerned about underage exposure to gambling or gambling-like activities, including sports betting ads, online games and features such as loot boxes. Concern was higher among households with children under 18.
Despite growing recognition of gambling addiction as a serious health issue, with 79% saying it is as serious as or more serious than drug or alcohol addiction, only 15% of respondents said a primary care provider had ever asked about their gambling habits, highlighting a gap in routine health screening.
