- Associated Press - Wednesday, July 30, 2014

DES MOINES, Iowa (AP) - Surveys show about 20 percent of adults in Iowa smoke regularly, but but a much smaller percentage acknowledged their habit when signing up for insurance with federally mandated forms.

According to the Centers for Disease Control and Prevention, about 20 percent of Iowans smoked in 2011. But when Wellmark Blue Cross and Blue Shield used federally required language to ask applicants about their tobacco use, only 7 percent acknowledged smoking, The Des Moines Register reported Wednesday (http://dmreg.co/1xzOJEG ).

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 said he’s surprised the percentage isn’t lower.

“I’m actually amazed at the number of people who have owned up,” Gold said.

Gold noted that smokers can qualify for lower rates if they try to quit.

West Des Moines insurance broker Jesse Patton said customers have told him they were smokers, then denied using tobacco when learning about the higher premiums.

Patton, the president of the Iowa Association of Health Underwriters, said he warns people that lying on an insurance form can be considered fraud, but customers apparently think it’s unlikely insurance companies could prove they were smokers.

Patton said the required federal language could be part of the problem, noting it doesn’t simply ask people if they have used tobacco but asks if they have used it on average at least four times a week in the past six months. Such a question could lead applicants to fudge the answer, he said.

David Brown, executive vice president at Wellmark, said the company tries to keep its tobacco surcharge low enough - about 15 percent extra - so people won’t lie. Brown acknowledged companies would have trouble checking on applicants.

“We don’t have drones,” he joked.

Insurance Commissioner Nick Gerhart said insurance companies can cancel policies if they find applicants have lied, and that could lead to huge medical bills.

Gerhart encourage people to take advantage of a rule giving them the non-smoker premium if they participate in a smoking-cessation service.

“That would be a much better thing to do, and a much healthier thing to do,” he said.

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