As Congress inches closer to passing a health care reform bill, many things remain uncertain, but one isn’t: Most of the bill’s major provisions won’t take effect until 2013.

Marc Young, assistant insurance commissioner at the Oklahoma Insurance Department, said the U.S. may see many of the bill’s payment mechanisms enacted within the next year, including tax increases and reductions in medical reimbursements. But none of its significant changes — specifically, federal tax credits to make insurance more affordable — will occur for about three years.

“This is an incredibly complex issue,” Young said. “It’s going to take some considerable time to get a lot of these provisions in place and enacted.”

But more time before health care changes could have an upside, such as giving employers more time to alter their business plans to line up with the new health care system, said Michael Lapolla, public health professor. He said it will also give people time to understand their health care options.

“This [wait] is not uncommon in government for something that’s fairly controversial,” Lapolla said.

Michael Givel, political science professor, stated in an e-mail that waiting three years could be problematic for Americans facing issues of cost and access to health care. But the proposed delay has led some Democrats in Congress to attempt to temporarily protect the private health industry, he said.

By the time health care is enacted, the U.S. will be in a new election cycle. Givel said Republicans may use this as a campaign issue against Democrats in the 2012 election.

“They quite likely will say that the Democrats, including President Obama, made substantial promises for better health care, but could not deliver anything for three years,” Givel said.

Givel said it is not yet known if any of the major health reform provisions will start immediately.

Although Congress is considering five different bills, it is not certain which one will pass, or exactly when, Lapolla said.

Givel noted it is also not known how the government will finance the health plan. He said Congress is debating between using federal tax credits or a public option to pay for health care. The tax credit option falls under the version written by Sen. Max Baucus, D-Montana, which eliminates the public option in favor of allowing taxpayers to write off part of their private health insurance costs from their federal income tax.

The public option would compete with private health insurance and could prove to be a direct threat to its profits and viability, Givel said.

Young said the Baucus version, or one similar to it, appears to be most likely to pass.

“I don’t think there’s really a clear sense of what’s going to happen with health care yet,” Young said. “I think it’s important that people manage their expectations on what happens with this issue.”

Givel said the issue’s heavy debate shows just how much is at stake in health care reform.

“The ongoing battle over the public versus private option, and particularly the proposed three-year delay, is a clear illustration of the power and influence of the private health care industry and its lobbyists with both major political parties,” Givel said.