In today's broadcasting environment, where`the only thing that really varies between stations in different markets is local news, and sports in some cases, I have a hard time understanding why cable carriage of out-of-market stations still has the limitations imposed on it that it does, unless it is the retransmission fees that are enough of a limitation all by themselves. Even in smaller markets adjacent to major ones, people still want their local news, and would seek it out even if distant markets were available.
Ending retransmission fees, and having multiple affiliates of major networks, probably wouldn't draw significant numbers of viewers away from in-market stations, unless it were a case of viewers being forced to rely upon stations that don't serve their local interests, such as the various counties in southeastern Kentucky that are forced into the Knoxville and Tri-Cities markets when they'd probably rather get Lexington stations, most of all WYMT Hazard. That is just one example. Carriage of OOM stations could be quite a shot in the arm to struggling cable providers, some of whom are closing shop entirely. With the capabilities of digital cable, surely lack of open channel slots isn't an issue anymore, and in-market stations could still be assigned to lower channel numbers.