The simple fact is, Visa/MC don't want to deal with porn because the number of chargebacks and fraud from porn purchases is significant and a huge outlier compared to most other charges. Their crusade against processing charges for adult material isn't about purity, it's simply business.
Given Valve's generous refund policies, and the fact that a steam store purchase on your credit card statement looks quite innocent, and that the credit card companies didn't complain to Valve about chargebacks but about content, my guess is there are hardly any chargebacks, and this is just about moral purity.
Fraud is likely more realistic of an issue, but that's probably an issue with games in general, not just adult titles.
There are already high-risk merchant accounts with higher fees and cash reserve requirements, but AFAIK companies like Valve aren't being given any options other than comply or be destroyed.
This is part of a long-term plan to de facto ban lgbtq content without having to deal with first amendment protections. First have the payment processors ban explicit content, then have queer content categorized as explicit.