President Obamas health care law has helped millions of Americans obtain insurance coverage, prescription-drug discounts and premium rebates but with only part of the overhaul in place and widespread confusion about what it does, the administration is still struggling to sell it to voters.

In the 2 years since Mr. Obama signed the Affordable Care Act, the administration has been frenetic in highlighting tangible benefits. On Tuesday, it announced that Americans saved $1 billion from rate increases that never happened but could have if the law didnt force companies to publicly justify any increases.

But the heftiest parts of the law, including a massive Medicaid expansion and the insurance exchanges estimated to cover 40 million uninsured, wont take effect until well after the November election, meaning most Americans arent seeing major changes.

Even when they are seeing benefits, they dont connect them with the law.

A lot of people may have noticed their flu shot was free this year, but might not have credited it to the Affordable Care Act, so I think a lot of the effects may have gotten unnoticed, said Tim Jost, a professor at Washington and Lee University who is a specialist on the health care law.

Meanwhile, health care costs continue to rise, complicating matters for the president, who promised that the law would bend the cost curve.

An annual survey released Tuesday by the Kaiser Family Foundation found that family insurance premiums cost $15,745 on average this year, 4 percent higher than last year. While the recession has slowed growth in recent years, premiums have nearly doubled since 2002.

The administration said the increases werent good but promised better news when the law is fully implemented.

We certainly arent happy to see any increase in health insurance premiums, and we look forward to when the provisions of the Affordable Care Act go into effect which will reduce premiums for American consumers and businesses, said Gary Cohen, who directs the Center for Consumer Information and Insurance Oversight at the Department of Health and Human Services.

Polls show that half the country opposes the law, and Mr. Obama didnt mention it in his speech last week at the Democratic National Convention in Charlotte, N.C.

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Selling health care law tricky on campaign trail