Coverage in the US has increased dramatically in the last 15 years. NBC has the Premier League rights at the moment, but apart from that and of course MLS you can now also watch some UK lower division league matches and all the Mexican, Italian, Spanish, German, French, Dutch, and South American league football regularly, including various domestic and international Cup competitions.
The cost of getting access to all of that at once is, in my opinion, a ripoff, but it is all available to Americans right now.