Iliana Mora, COO of Erie Family Health Center, talks about the Affordable Care Act.

As political debate continues to rage over President Barack Obama's signature health care overhaul, the law already is reshaping health care in the most troubled communities in Chicago and its suburbs.

Since 2010, Illinois health clinics have received more than $50 million in development grants under the Affordable Care Act to build new facilities, expand operations, modernize equipment and improve the overall quality of care for the state's poor and uninsured.

The money has sparked a building boom for health centers across the region and is ushering in a new era of competition to care for the growing pool of insured Americans. Supporters say this competition will drive down costs for patients and expand their options, allowing them to shop around for the best care and not just the most affordable.

But competition is a new challenge for small community health clinics that operate on shoestring budgets. As treating the poor becomes more profitable, bigger and better-funded medical centers are expected to seek a larger share of the marketplace.

"If the larger organizations decide they're going hard after all those newly insured patients, you could see a feeding frenzy," said Dr. Robert Winn, associate vice president for community-based practice at the University of Illinois Hospital & Health Sciences System. "I hope it doesn't happen, but I'd be wary of it."

On Chicago's West Side, work crews this week continued to install the glass and metal exterior on a $44 million five-story clinic that will treat four times the number of patients seen at the university system's current largest facility.

Six miles north, construction is winding down on a new 24-room health center with updated technology and even a rooftop garden. When it opens this fall, it will be the ninth clinic run by the nonprofit Near North Health Service Corp.

In Waukegan, on a commercial street lined with taquerias and other Latino-owned businesses, the Erie Family Health Center of Chicago is embarking on a $7 million renovation of a vacant bank building into a modern medical facility.

And on Chicago's Far South Side, in the historic but blighted Pullman neighborhood, city officials recently joined employees of the Chicago Family Health Center at the opening of a sun-filled $10 million health clinic that triples the capacity of the cramped center it's replacing.

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Will health care boom harm small clinics?