The New York Times on Wednesday carried a provocative front-page dispatch from Kentucky by Abby Goodnough, who’s been doing a superb job of covering the impact of the Affordable Care Act in the Bluegrass State as a window into the law’s import nationally. The piece captures the political dynamic in Kentucky, where Obamacare has slashed the rate of the uninsured from 20.4 percent to 11.9 percent, the second largest drop after Arkansas, but where this success is seemingly not redounding to the benefit of Secretary of State Alison Lundergan Grimes, who is now lagging in the polls against Mitch McConnell. This is indeed a conundrum for Grimes, but I worry that the piece, well-reported as it is, may leave many readers with a slightly mistaken impression—and place the blame for Grimes’ dilemma in the wrong place.

Goodnough quotes Kentuckians who are, themselves or their close family, benefitting from Obamacare, but are nonetheless planning on voting Republican. For instance:

The Affordable Care Act allowed Robin Evans, an eBay warehouse packer earning $9 an hour, to sign up for Medicaid this year. She is being treated for high blood pressure and Graves’ disease, an autoimmune disorder, after years of going uninsured and rarely seeing doctors. “I’m tickled to death with it,” Ms. Evans, 49, said of her new coverage as she walked around the Kentucky State Fair recently with her daughter, who also qualified for Medicaid under the law. “It’s helped me out a bunch.” But Ms. Evans scowled at the mention of President Obama—“Nobody don’t care for nobody no more, and I think he’s got a lot to do with that,” she explained—and said she would vote this fall for Senator Mitch McConnell, the Kentucky Republican and minority leader, who is fond of saying the health care law should be “pulled out root and branch.”

No doubt, there are many GOP-inclined voters like Ms. Evans among the several hundred thousand Kentuckians who have obtained coverage under Obamacare. Their existence, and quotes like this, only confirm one of the most popular conceptions of red state politics in the minds of blue state liberals: the “What’s the Matter with Kansas” notion that lower- and middle-class white voters in these states are voting Republican even though their economic interests are far better represented by Democrats. How else to explain that a state like Kentucky could be benefitting so much from the law and yet be leaning Republican?

But this likely takeaway from the piece—like the "What's the Matter with Kansas" thesis more broadly—may oversimplify things. For starters, my strong hunch from my own reporting in the region over the past couple years—including several trips to Kentucky for a new book on McConnell—is that the Democrats’ biggest problem in Appalachia and the Upland South is not that the people who are benefitting from Obamacare or would stand to benefit from it if their states fully implemented the law are voting against their own interests, for Republicans. It is that many of those people are not voting at all.

Remember, the vast majority of Obamacare’s beneficiaries in states like Kentucky that expanded Medicaid are poor, with incomes below 138 percent of the poverty level, the threshold up to which Medicaid coverage is to be expanded under the law. And poor people famously vote at far lower rates than everyone else, with turnout lower in Appalachia than just about anywhere. When I spent a weekend in 2012 in the mountains of eastern Tennessee at a free health clinic full of people who would be covered under the law’s Medicaid expansion, I was expecting a “What’s the Matter with Kansas” type reaction—people who were meant to be the law’s main beneficiaries railing against Obama. Instead, the prevailing attitude toward Obama was far more sympathetic—the clinic attendees generally felt like he was on their side. There were just two problems: they had virtually no inkling of the law’s intended benefits for them. And, even more crucially, most of them said they generally did not bother to vote.