A proposal before Connecticut lawmakers would require insurance companies to cover the surgery for people with a body-mass index of 30 or more if a doctor deems the surgery medically necessary.
The Connecticut proposal may not get off the ground this session because lawmakers are struggling to define under what medical conditions the surgery should be covered, said Sen.
Georgia lawmakers are considering a similar bill this year.
And in Louisiana, 40 state employees were chosen last year from 1,200 applications to get the surgery on the state's dime.
The standard surgery, which can cost between $20,000 and $35,000, involves using staples to separate a small pouch at the stomach's top from the rest of the stomach, greatly limiting the amount of food that can be eaten.
Blue Cross and Blue Shield of Alabama recently stopped paying for the operations while it decides how to handle claims; Blue Cross and Blue Shield of Florida has also decided to stop paying for the operation.
In Connecticut, many major plans offer coverage only for large numbers of employees.
Others are considering offering the coverage for an additional charge.
"Many plans decide the best course of action simply is to exclude coverage."
But many physicians say the long-term benefits of weight loss surgery outweigh the risk.
Gastric bypass surgery can help cure obesity-related health problems such as high cholesterol, high blood pressure, sleep apnea and even diabetes, said Dr. Jonathan Aranow, director of the Middlesex Hospital Center for Obesity Surgery.
It can also cut down on the long-term cost of medications, he said.
Complications strike as many as 1 in 5 patients having the surgery, and it is believed that for every 200 patients, 1 to 4 will die.