12/28/09 HC Reform Update by Mark Sanna: Many major provisions in the health care legislation would not begin until 2013 under the House bill, and 2014 under the Senate bill. On the flip side, many of the new taxes and fees that will help pay for the legislation would take effect much sooner. For this reason, some Republicans have criticized the bill as akin to legislation on a layaway plan: pay now for benefits later.