One of the most striking—and disturbing—takeaways from Tuesday’s West Virginia Democratic primary were exit polls that found large numbers of Bernie Sanders supporters saying if not Bernie, they would actually vote for Donald Trump next fall.

CBS News reported 44 percent said they’d vote for Trump, 23 percent for Hillary Clinton, and 32 percent for neither. These findings—especially Sanders’ supporters shifting to Trump—seem like a stretch, but maybe they’re not.

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“West Virginia was once a solid Democratic state, a hotbed of labor unionism that went for Democratic presidential candidates from 1932 on in all but the Republican landslide years of 1956, 1972, and 1984… but more recently, the state has trended Republican, for a variety of reasons,” wrote The Atlantic’sDavid Graham. “Party realignment around conservative issues has led socially conservative West Virginians toward the GOP; racial animus toward President Obama has hurt the local Democratic Party; and the combination of weaker unions and liberal environmental advocacy against coal has lost the Dems some blue-collar backing.”

West Virginia is not a mirror of the rest of the country, although its economy and demographics resemble a lot of the Midwest and Appalachia. As Patrick Murray, director of the Monmouth University Polling Institute, told AlterNet earlier this week, Sanders supporters do not just include younger people and progressives who feel President Obama’s promises in 2008 “never materialized.” They also include “anti-Hillary white males” who are not enamored with Bernie Sanders and don’t like Hillary either.

The question for millions of Sanders supporters nationwide is not so much are they going to vote for Trump, but whether they will vote for Clinton if she edges out Sanders for the Democratic nomination. The campaign has a Bernie or Bust subset, whose website claims it has “99,000+ people” who vowed to write in Sanders’ name or support the Green Party candidate in November, and hopes its ranks will reach 1 million people.

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On Tuesday, Clinton resurrected a progressive health care reform idea, suggesting people age 50 and older could buy into Medicare, the federal safety net for seniors. As the New York Times noted, “Mr. Sanders calls his health care plan ‘Medicare for all.’ What Mrs. Clinton proposed was a sort of Medicare for some.”

Obviously, Sanders has pulled Clinton to the left. But this latest contrast is a perfect illustration of the conundrum facing Sanders’ supporters. Is it satisfying or a disappointment to support a candidate like Clinton who is pledging to deliver half-measures when compared to Sanders? Or is it pragmatic and what progress actually looks like?

President Obama weighed in on this very issue when speaking last Saturday to Howard University’s graduating class. Be confident, he said. Be aware of your history. Be a voice for the voiceless. Don’t act entitled. Be passionate, but be strategic. “Change requires more than righteous anger,” Obama said. “It requires a program.”

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“And democracy requires compromise, even when you are 100 percent right,” hesaid. “This is hard to explain sometimes. You can be completely right, and you still are going to have to engage folks who disagree with you. If you think that the only way forward is to be as uncompromising as possible, you will feel good about yourself, you will enjoy a certain moral purity, but you’re not going to get what you want. And if you don’t get what you want long enough, you will eventually think the whole system is rigged. And that will lead to more cynicism, and less participation, and a downward spiral of more injustice and more anger and more despair. And that's never been the source of our progress. That's how we cheat ourselves of progress.”

Right now, Bernie Sanders supporters are not likely to be very receptive to this kind of wise counsel, which describes how incrementally improving the system can be seen as moving positively along the arc of history. Part of that is because Sanders is now enjoying another bump in primary states where he’s nominally winning, last week in Indiana and this week in West Virginia—but he’s not really cutting into Clinton’s lead in delegates. Next week that is likely to continue in Oregon and Kentucky, which makes the June 7 primary in California a make-it-or-break-it finish line for the two. It’s even possible that should Sanders narrowly win California the proportional allocation of delegates would still clinch the nomination for Clinton. (New Jersey also votes that day and she has a double-digit lead there in polls.)

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So what lies ahead is another month where the most ardent Sanders supporters are likely to see incremental wins but are likely to fall short of the nomination. That kind of backdrop could make it even harder for them to support Clinton in the short run. It also raises questions about whether they can do that in the long run—by next fall.

Meanwhile, in states like West Virginia, more than 40 percent of Sanders supporters claim they will vote for Trump next fall if it comes down to that.

This doesn’t look like it will end well—especially if Trump is seen as the agent of change in 2016, and Clinton, for all of her proposed pragmatic steps forward, is seen as barely budging the status quo.