Mark Bertolini, the CEO of influential insurance company Aetna did an interview with Kaiser Health News yesterday in which he talked candidly about his company’s perspective on the individual mandate in the new health care law.

His blunt take on the individual mandate was that “it’s pretty likely that [the mandate] won’t survive the constitutional challenge,” at which point “we’ll have a whole different ballgame” because “there isn’t anyone who thinks [the law] can stand without the individual mandate.”

More specifically he says “We don’t think that in the individual mandate in the Affordable Care Act is strong enough because the penalty for not having coverage isn’t high enough.”

The power in these statements comes from the fact that Aetna, along with other large insurance companies, is one of the largest beneficiaries of the health reform law.

If a company CEO who should be pushing for the mandate cannot defend the constitutionality of it and claims it won’t be around for much longer, then why are states moving forward with only one game plan? Shouldn’t we be thinking about alternative solutions to mandates and exchanges and taking time to see what’s most likely on the horizon?