GAINESVILLE, Ga. - Emma Collins, a licensed massage therapist from Ellijay, was hopeful about the new federal health care law after struggling in recent years to find insurance coverage because her artificial heart valve is considered a pre-existing condition.

Then Collins said she began researching plans for her and her family and realized the costs would simply be too much to cover everyone. The 47-year-old testified at a congressional field hearing Monday in Gainesville that she and her family expect they will have to pay a penalty for not having insurance.

"I think that it is great to help those that are poor and desperately need help, but that is not what is happening," Collins said at the hearing. "Because of the (Affordable Care Act), we will go from having some health care coverage we can afford to not having any coverage and facing a fine."

More than 100 people packed into a government meeting room for the field hearing held by the House Oversight and Government Reform Committee on the effects of the health care law on rural communities. Leading the hearing was Republican Rep. Rob Woodall, of Lawrenceville, who said the goal was to hear of the "real-world implications" of the law and solutions for reforming the health care system.

The hearing was largely critical of the law and President Barack Obama. A small group of activists attended the meeting in the hopes of being able to testify about the need for Medicaid expansion in Georgia, which is a key element of the federal law but something Gov. Nathan Deal has said would be too expensive for the state to implement.

"We believe by expanding Medicaid we would be able to help those people who fall in the gap," said DeLane Adams, communications director for the Georgia AFL-CIO. "When it comes to health care, it's a non-partisan issue."

Adams and the others weren't able to testify since the schedule was set in advance. A committee spokeswoman, Caitlin Carroll, said Democrats who sit on the committee could have attended and also selected witnesses to testify. The only congressional representatives at the hearing were Republicans.

In a statement issued ahead of Monday's hearing, Democratic Rep. Elijah Cummings of Maryland, ranking member of the committee, said House Republicans have made it clear they have no interest in making improvements.

"Rather than engaging in a destructive political exercise with the ultimate goal of tearing down the Affordable Care Act, promoting misinformation, and eliminating health insurance for tens of millions of people, the committee should support constructive efforts to help educate and assist families who urgently need medical care and now have a chance to obtain it," Cummings said.

The U.S. Department of Health and Human Services says 94 percent of Georgia's uninsured and eligible population, or about 1.5 million residents, would qualify either for tax credits or Medicaid if the state expanded the program. The department also says 3,726 Georgia residents with pre-existing conditions have already gained coverage due to the law.

Republican Rep. Doug Collins of Gainesville said the law has had "devastating effects" on Americans and told the story of a local pharmacist who closed his business because of compliance costs and uncertainty associated with the law.

"Costs to the person may go down for some, and it will go up for others," Collins said. "But for everybody as taxpayers, you are going to pay for this no matter what."

Raymer Sale, who owns an insurance company in Duluth, said his clients are facing significant challenges under the law.

"This law is complex and doesn't protect everyone, nor is it affordable," Sale said. "We are being led to believe policies in effect prior to 2014 are inferior, but inferior to whose standards? Most of these insurance policies were designed to fit patient needs."

Emma Collins, who said she lives each day with the risk of a stroke, said the basic plan that currently covers her husband and daughter for $265 a month will no longer be offered and the family has been told that a comparable plan would cost $898 monthly.

"My story is one of many," Collins said after the hearing. "It's coming out that the reality of this is not what any of us were expecting."