The U.S. House Republican leadership released the new Appropriation Act, or funding bill, late last night (here). The entire package totals $1.1 trillion, but it includes several significant items that will directly impact the funding of the Affordable Care Act (ACA), or Obamacare.

The spending deal delays the "Cadillac Tax" on high cost insurance plans and the medical device tax for two years. It also delays the tax on health insurance premiums for one year. The deal continues the non-funding of the Independent Payment Advisory Board and provides no money for the ACA's Prevention and Public Health Fund or what some call the "Obamacare slush fund." The majority of new Obamacare taxes and the severe cuts to Medicare remain in place, however.

There evidently is a degree of bi-partisan support for the deal, unlike when the ACA passed along strict party lines in 2009.

The new Appropriation Act will be a minor reform of the ACA, but may be a significant first step to meaningful reform or actual repeal of Obamacare.