Community health centers were among the big winners in the health care overhaul since the law provided $11 billion over five years to expand their ability to see millions more patients.

But hundreds of health centers aren't feeling so lucky any more.

That's because the Obama administration scaled back some of the expansion plans this year after the federal budget compromise reached in March trimmed government spending.

The budget deal between the White House and Republicans cut $600 million, or half the regular 2011 appropriation for the health centers. To lessen the pain, the administration filled in for those missing dollars with money slated to staff and build new centers. As a result, the expansion dollars for this year became much more limited.

Rather than handing out $250 million to establish new patient care sites to serve more than 2 million additional people as originally expected, the Obama administration gave $29 million to 67 nonprofit organizations that will serve an additional 286,000 patients. A total of 810 nonprofits had applied.

In addition, to free up money to help with existing operations, the administration scrapped plans to distribute $335 million to health centers to boost medical, dental, pharmacy and vision services.

Advocates are concerned that future congressional spending cuts could slow efforts to build health center capacity by 2014, when the health law will begin expanding coverage to 32 million uninsured. "Now the whole process has been set back," said Dan Hawkins, senior vice president at the National Association of Community Health Centers.

At the local level, the funding changes mean:

"When the money first became available, a lot of community organizations said here's a golden opportunity, let's try to take advantage," said Heartland CEO Jon Stewart. "But like many others, we were shocked not to be awarded a grant."

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