Al Franken is an idiot (pardon me for borrowing from Franken's obnoxious title "Rush Limbaugh Is a Big Fat Idiot")
Senator Thune clearly states that the "spending" benefits from the proposed Democrat health care plan in the Senate doesn't kick in until 2014. So what does Al Franken start yelling about? His first example is a regulation that starts immediately (now we could point out that the benefit he mentions will actually raise costs by more than the benefits or insurance companies would already be offering it, but that is somewhat besides the point). The next example is a tax credit.