Anthem and Humana, among others, are on the record as saying they have chosen to drop commissions to help keep rates down. According to Humana spokesman Mark Mathis, while insurers view agents as “an important source of information and guidance,” changes must sometimes be made to help maintain “sustainable and affordable health plans for our members.”

The report came close on the heels of a study from Blue Cross Blue Shield that supports what many insurers have been arguing since day one: PPACA enrollees are sicker and more expensive. Specifically, they are more likely to suffer from diabetes, high blood pressure, high cholesterol, heart disease, HIV/AIDs, and depression.

The cost of medical care for new enrollees in ACA plans was 19 percent higher in 2014, and 22 percent higher in 2015 compared to those enrolled through employer plans by BCBS companies for the same period, the study found.

As you would expect, the Centers for Medicare and Medicaid Services (CMS) described the report as “seriously flawed.”

Other reports show that insurers are also cutting agent commissions to lower costs by reducing the number of sick people who enroll. But as Peter Lee, executive director of the Covered California exchange told USA Today, it “flies in the face of the ACA … to say in code to agents, 'Don't bring us sick people,' or to make it harder for some to enroll.”

Looking for a potential bright spot amidst all the confusion and gloom? The post-ACA landscape continues to provide a boon for voluntary sales, as evidenced by the 2016 Benefits Selling/Eastbridge Voluntary Benefits Survey (page 33). Nearly 70 percent of respondents said they are selling more voluntary due to ACA, with one-quarter indicating they're selling “significantly more.”

Clearly, the last six years have done little to provide clarity or consensus. And two of the remaining GOP presidential candidates provide little reason for optimism to those still dreaming of repeal. Ohio Governor John Kasich has described the Republican vow to repeal Obamacare as “stupid,” while defending the Medicaid expansion that he implemented in Ohio through the ACA. And although Donald Trump has described PPACA as a “disaster,” he has also said multiple times that he believes the government can provide affordable coverage to all citizens. Almost sounds like he lifted the line from Bernie Sanders, doesn't it?

The ongoing turmoil and uncertainty remains challenging for brokers, which is one of the reasons why Reed Smith is such a perfect choice for our 2016 Broker of the Year (page 12). For years, Smith, a champion of consumer-driven health care, has hosted a monthly webinar to educate his clients about the ACA .

“In a post-ACA world,” Smith says, “employers don't need a broker or an agent … They need an advisor or a consultant to address a more holistic view of benefits.”

I guess the alternative is to stick your head in the sand and wait for it all to go away. But when you decide to look again, don't be surprised if the new landscape is unrecognizable.