That is a significant problem. However, the corruption problem remains on top of the list. Just look at the description of the New York system. That's a racket and worse than many I've read about. Didn't happen accidentally.
So, you have the corruption-driven blockades at federal and state-levels along with the natural regulation that will exist at either level. Quite a pain to deal with.
But that would require a huge reform of the USA's political system which is never going to happen.