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The United States had to recover from a blown lead to defeat Canada 4-3 in a shootout to move into the Hlinka Gretzky Cup final on Friday.
USA had a two-goal lead in the third period that was extinguished by goals from Canadian forwards Tynan Lawrence and Mathis Preston.
Joseph Salandra, Nikita Kelpov, Blake Zielinski scored in the shootout while Brady Knowling made three stops to secure the victory.
Noah Davidson, Luke Puchner, and Zielinksi also scored for the United States while Knowling picked up the win after making 34 of 37 saves.
Ethan Belchetz scored the remaining goal for Canada.
Betts took the loss for Canada after allowing three goals on 32 shots.
The United States will move on to face Sweden for gold on Saturday while Canada will battle Finland in the third-place game.
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