Insurance-denied bariatric surgery: Under the Affordable Care Act, whether an individual health plan covers bariatric surgery depends entirely on which US state a patient lives in. Virginia, Texas and Florida's current benchmark plans exclude it outright, while California law requires it as a basic covered service. Your Care Promise's US page walks through this state-by-state gap and what it means for a patient whose plan simply doesn't include the surgery, not because of their case but because of their zip code.