Protester at Senate health hearing on Sept. 25, 2017.(Photo: Jim Lo Scalzo, epa)

Take it from someone who has overseen the implementation of a massive new health care law: For all the promises Republicans have made about repealing and replacing the Affordable Care Act, a bill like the one they aim to pass this week would not just hurt people, it would enmesh the GOP in an unworkable quagmire. 

Support for the Graham-Cassidy bill — including from Republicans — was weak and getting weaker as more details spilled out and more last-minute changes were made. So far, seven Republican governors have spoken out against the bill and many Republican Medicaid directors signed a letter condemning it further. 

More: Health care smackdown: Last-ditch repeal drive threatens bipartisan fixes

More: Health care truth GOP must accept: America doesn’t want a free market yet

In fact, the further away from Washington you get and the closer to patient care, the worse the bill looks. It’s been pilloried by groups that represent patients, physicians, hospitals and insurers. They say it will “undermine safeguards,” “millions of patients will lose their coverage,” and it will make coverage “more expensive.” Equally damning, they label the bill “not workable.” And for all these flaws, it’s the highly partisan approach that would do in the bill and its sponsors.

I came to Washington in 2013 to fix the botched ACA rollout and then lead a successful implementation of the overall law. We made significant gains, most notably in covering millions more Americans and eliminating discrimination against people with pre-existing conditions. All of that would be lost under Graham-Cassidy. But our gains would have been so much greater if we’d had even a portion of the bipartisan support that new laws usually enjoy.

Bills are signed with Rose Garden ceremonies on Day 1. But Day 2 matters just as much. What Republicans would pass with Graham-Cassidy on Day 1 is a commitment to some principles, like federalism that gives responsibilities to the states. Those would have to be translated on Day 2 into a series of nitty-gritty actions and activities — federal rulemaking, state legislative debates and highly technical work involving new laws, regulations, technology and service centers, all the while educating the public on 50 brand new approaches to health care. 

Let me describe what carrying out Graham-Cassidy would feel like. We would see the complexity of healthcare.gov times 50. We’d need the equivalent of 50 Centers for Medicaid Services to design new policies, 50 enormous legislative efforts, and 50 heavy lifts on technology. Hundreds of lobbyists, consultants and vendors would descend on D.C. and state capitols peddling model legislation and technology — most of which won’t work at first. With inadequate resources and a compressed time frame, best case, many states would end up petitioning to cling to the system they have under the ACA — except that given the draconian changes in Graham-Cassidy, they end up with chintzier subsidies, few consumer protections and higher premiums for many.

These challenges would multiply under a law passed in an acrimonious, partisan and rushed fashion without anything close to regular order — hearings, experts, debates and a real analysis from the nonpartisan Congressional Budget Office. I wouldn’t expect Democrats to pull the same tricks Republicans did to hurt the Affordable Care Act, such as slashing funds meant to stabilize rates, defunding new competitors, refusing to expand coverage, or sabotaging outreach efforts. But I expect both Democrats and consumer advocates would be out to protect consumers in any way possible from losses in coverage and new forms of discrimination. And when inevitable challenges require congressional or state legislative fixes, the Republicans would need large majorities in state houses and governorships or they will be shy of that support.

More: Trump voter who survived cancer: Graham-Cassidy health bill worst by far

POLICING THE USA: A look at race, justice, media

The better way — ultimately, the only right way — is reviving bipartisan talks that Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., began earlier this month. Give me an 80% solution, but one where everyone has a stake in the outcome, over something developed in a think-tank with principles that can’t withstand day 2.

This is not what Americans want. Consider what the ACA might look like today if it had benefited from bipartisan support over the last seven years: Millions more covered through Medicaid, more competition and lower premiums, more certainty for all — and maybe even a follow-up law with conservative and liberal ideas that would have closed gaps and taken us someplace entirely new. 

The most partisan ideas on both sides should be put to the test of developing enough consensus to achieve a filibuster-proof 60 votes in the Senate. Until then, we should improve the ACA — originally an imperfect center-right idea first tried in Massachusetts, now at work across the country — and make gradual moves toward universal coverage and lower costs.

This week’s effort to create payoffs for targeted senators like Lisa Murkowski of Alaska, and to jam in last-minute changes that rip out even more consumer protections, miss this point entirely. Only by working together diligently will we ensure that a good Day 1 is followed by a good Day 2.

Andy Slavitt, a member of USA TODAY’s Board of Contributors, is a former health care industry executive who was acting administrator for the Centers for Medicare and Medicaid Services from 2015 to 2017. Follow him on Twitter: @ASlavitt.

You can read diverse opinions from our Board of Contributors and other writers on the Opinion front page, on Twitter @USATOpinion and in our daily Opinion newsletter. To respond to a column, submit a comment to letters@usatoday.com.