In March 31, 2016, HHS-Operated Risk Adjustment Methodology Meeting Discussion Paper (March 24, 2016) discussed the concept of varying cost-sharing levels. In the HHS-HCC risk adjustment model, diverse levels of cost-sharing have been incorporated into the insurance plans. The Affordable Care Act (ACA) established four health plan tiers which are referred to as metal levels. The levels are:

• Platinum 90/10 plan
• Gold 80/20 plan
• Silver 70/30 plan
• Bronze 60/40 plan

Examine this structure from the viewpoint of moral hazard. How would members in the different metal levels make decisions about healthcare services? Do you think four levels of cost-sharing meet the needs of the US healthcare market?