Cite as: 503 U. S. 347 (1992)
Blackmun, J., dissenting
ous possible methods of calculating reimbursable costs would best promote efficient operation of health-care facilities. See Wilder, 496 U. S., at 506-507. The Court further noted that Congress chose a standard that leaves the States considerable autonomy in selecting the methods they will use to determine which reimbursement rates are "reasonable and adequate." Id., at 506-508, 515. The result, of course, is that the "content" of the federal right to reasonable and adequate rates—the method of calculating reimbursement and the chosen rate—varies from State to State. And although federal judges are hardly expert either in selecting methods of Medicaid cost reimbursement or in determining whether particular rates are "reasonable and adequate," neither the majority nor the dissent found that the right to reasonable and adequate reimbursement was so vague and amorphous as to be "beyond the competence of the judiciary to enforce." See id., at 519-520; id., at 524 (Rehnquist, C. J., dissenting). State flexibility in determining what is "reasonable," we held,
"may affect the standard under which a court reviews whether the rates comply with the amendment, but it does not render the amendment unenforceable by a court. While there may be a range of reasonable rates, there certainly are some rates outside that range that no State could ever find to be reasonable and adequate under the Act." Id., at 519-520.
The same principles apply here. There may be a "range" of "efforts" to prevent unnecessary removals or secure beneficial reunifications that are "reasonable." Ibid. It may also be that a court, in reviewing a State's strategies of compliance with the "reasonable efforts" clause, would owe substantial deference to the State's choice of strategies. That does not mean, however, that no State's efforts could ever be deemed "unreasonable." As in Wilder, the asserted right in
371
Page: Index Previous 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 NextLast modified: October 4, 2007