BICEP2 has reported the detection of a degree-scale B-mode polarization pattern in the Cosmic Microwave Background (CMB) and has interpreted the measurement as evidence for primordial gravitational waves. Motivated by the profound importance of the discovery of gravitational waves from the early Universe, we examine to what extent a combination of Galactic foregrounds and lensed E-modes could be responsible for the signal. We reanalyze the BICEP2 results and show that the 100x150 GHz and

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... GHz data are consistent with a cosmology with r=0.2 and negligible foregrounds, but also with a cosmology with r=0 and a significant dust polarization signal. We give independent estimates of the dust polarization signal in the BICEP2 region using four different approaches. While these approaches are consistent with each other, the expected amplitude of the dust polarization power spectrum remains uncertain by about a factor of three. The lower end of the prediction leaves room for a primordial contribution, but at the higher end the dust in combination with the standard CMB lensing signal could account for the BICEP2 observations, without requiring the existence of primordial gravitational waves. By measuring the cross-correlations between the pre-Planck templates used in the BICEP2 analysis and between different versions of a data-based template, we emphasize that cross-correlations between models are very sensitive to noise in the polarization angles and that measured cross-correlations are likely underestimates of the contribution of foregrounds to the map. These results suggest that BICEP1 and BICEP2 data alone cannot distinguish between foregrounds and a primordial gravitational wave signal, and that future Keck Array observations at 100 GHz and Planck observations at higher frequencies will be crucial to determine whether the signal is of primordial origin. (abridged)