DES MOINES, Iowa (AP) – Surveys show about 18 percent of adults in Iowa smoke regularly, but less than half that percentage acknowledge smoking when signing up for insurance with federally mandated forms. The Des Moines Register reports when Wellmark Blue Cross and Blue Shield used federally required language to ask applicants about their tobacco use, only 7 percent acknowledged smoking.

The Affordable Care Act doesn’t allow insurers to charge more for customers with many health problems, but it allows higher fees for regular tobacco users. CoOportunity Health, which also uses the tobacco language on its application forms, imposes a 49 percent surcharge on smokers in its individual insurance policies.

Only 5 percent of applicants acknowledge smoking, and CoOportunity chief operating office Cliff Gold says he’s surprised the percentage isn’t lower, given the charge.