The recent demise of the American Health Care Act (AHCA), a legislative package proposed as the vehicle to repeal and replace the Affordable Care Act (ACA), leaves health care providers and patients with uncertainty about what the future holds regarding federal health care policy reform. In the meantime, the ACA remains the law of the land. For health care providers, insurers, and patients in Virginia, that is not without complicating considerations. Under the ACA, for instance, Virginia hospitals face $3.6 billion in federal funding cuts from 2017-2026. In Virginia, those cuts are not being offset by a dramatic shift in uninsured Virginians becoming insured through provisions of the ACA. What that means is Virginia’s hospitals and health systems continue to face the impact of these funding cuts and the financial strain of providing uncompensated charity care to patients who are uninsured and under-insured. The latest edition of VHHA’s monthly FOCUS publication explores the state of play regarding federal health care policy reform efforts and the implications for Virginia’s health care providers and patients.