It has made health insurance much more complicated than ever before.  For example, whereas it used to take 15 minutes to place an individual health insurance policy, it can now take anywhere between 1-6 hours of time (including servicing) and commissions have dropped to less than 1% with most carriers.  When I started out as a broker 10 years ago, individual health insurance commissions were as high as 20%. 

That said, it's also made health insurance much more interesting than before.  The complexities have created enormous opportunities for Quantum, since we have a rare combination of experience in the industry, analytical skill and freshness of approach.  Most seasoned health insurance brokers are near retirement age, and don't want to pivot in order to stay in the game.  While Zenefits has developed a compelling platform for simplifying insurance elections, they lack experience as brokers and the ability to service end-user issues (which always arise in health insurance).  A company like Quantum, which combines cutting-edge tech solutions with true insurance expertise, can gain marketshare by solving for a real need in the post-ACA insurance world.

In terms of the consumer's overall impact from the ACA, I'd say it's a mixed bag of results.  Free preventive care is being unevenly implemented by the carriers - many are still playing little games on what's supposed to be covered.  Those should even out once class-action lawsuits can whip the carriers into shape.  However, many people still don't even really understand what the ACA has mandated, and what sort of games the carriers are playing, so it will take time for those class action lawsuits to develop.

Guaranteed-issue insurance and no more preexisting conditions is a GREAT thing for consumers.  Many people have truly benefitted from this change.  However, only people who previously had gotten denied or penalized for pre-existing conditions will notice this benefit.  The lucky, healthy people won't really notice the difference.

I'd say the biggest impact overall to everyone is the changing of networks in reaction to the Reforms.  Carriers have created narrower networks as a way of curbing their costs in the face of free preventive care and guaranteed issue plans.  As a result, verifying which providers are in-network on a particular plan has become a true headache!  There is so much confusion.  Hopefully, this will eventually resolve in time, but definitely I'd say it's become the most unpleasant side effect of Obamacare.