What are high-risk pools and how do they work? You should care about high-risk pools, because they're the latest attempt at health care overhaul by Speaker of the House Paul Ryan (R-Wis.). Already famed for his magic asterisks and out-there tax proposals, Ryan has spearheaded a new health care proposal as part of House Republicans' major policy rollout A Better Way. Although he buried it in a bullet point on page 21, Ryan would like to use high-risk pools as his get out of jail free card for repealing the most popular provisions of the Affordable Care Act, also known as Obamacare.