Creates a federal rule that makes most sports wagering illegal unless it is run under an approved State or Tribal sports wagering program that meets federal minimum standards. It requires licensing, recordkeeping, data security, real-time data sharing, suspicious transaction reporting, and Attorney General oversight of State programs.

Adds national public‑health actions tied to online sports betting: an annual survey of problem gambling, a national self‑exclusion list people can join to block wagering, a Surgeon General report to Congress, and planning for a national surveillance system for gambling addiction. The law preserves State and Tribal authority over gaming and taxation while requiring cooperation to block unlicensed offshore operators and protect consumers and contest integrity.