I started on hard, and it isn't too hard you regen fast and if you die you can auto-defib yourself back to life. The defib is on a fairly short timer as well.
I am impressed with the AI they react when you shoot them and the melee guys that charge don't run in a straight line, the wall run and flip off things in the environment, I've only fought 2 or 3 factions, havn't seen the Authority yet.
I am expecting nightmare to be a challenge though, based off hard mode.