Creates a national framework for sports betting. It generally bans accepting sports wagers unless a State chooses to opt in and runs a program that meets federal minimum standards and is approved by the U.S. Attorney General. Those standards include strong consumer protections, limits on risky bet types and promotions, event‑integrity safeguards, data and recordkeeping rules, and responsible marketing.

Adds public‑health measures tied to online sports betting: an annual national survey, a nationwide self‑exclusion list, a Surgeon General report to Congress, and CDC‑led surveillance for gambling disorder with guardrails that limit industry influence. It preserves State and Tribal authority (including taxation), clarifies where an online wager is legally placed, and requires cooperation to combat unlicensed overseas platforms. Violations face federal penalties and enforcement.