Pennsylvania’s online casinos need new regulations that would transform how they are allowed to operate, according to a state report on options to address what some mental health experts are calling “an urgent and escalating public health challenge.” But at the heart of a new state report on gambling addiction is a choice that isn’t resolved: Should Pennsylvania address the problem quickly and risk denting the gambling industry’s revenue, or study it more carefully and issue targeted changes more slowly?The report Pennsylvania’s bipartisan Joint State Government Commission released on Monday says the commonwealth could address gambling addiction quickly by instituting a number of changes, including:1. Making it illegal to gamble with a credit card2. Requiring gamblers to place self-imposed limits on their betting3. Creating new restrictions on advertisements.The legalization of online casinos in Pennsylvania in 2017 has led to the creation of the largest online gambling market in the country. The commonwealth’s $7.7 billion in total gambling profits in 2025 now rivals all of the casinos on the Las Vegas Strip and its profits are growing 10 times as fast as Nevada’s. Pittsburgh is the fifth-largest market for gambling advertisements in the country, according to one recent report; Philadelphia is first.