Chuck Grassley just can’t escape death panels.

Back in 2009, the Iowa senator suggested that the Affordable Care Act might create something akin to a “death panel,” where the government decides which patients survive. In remarks at a town hall, he seemed to endorse the idea that the health care law had a program meant to ration end-of-life medical care. (It didn’t.)

This week, eight years later, Grassley had another town hall, and “death panels” came up again. But this time, the term meant something very different — because Obamacare supporters, not critics, were the ones saying it.

Grassley’s quote at the 2009 town hall became infamous, echoing through the following months and years of health care debate. “And I don't have any problem with things like living wills, but they ought to be done within the family,” Grassley said then. “We should not have a government program that determines you're going to pull the plug on Grandma.”

The death panel myth had incredible staying power. PolitiFact ended up naming it the “lie of the year” in 2009. The group cited Grassley as a “prominent Republican [who] didn’t reject the death panels claim.” Six years later, in 2015, some people still believed it: A Vox poll that year found 26 percent of Republicans and 12 percent of Democrats believed the ACA created a “government panel that helps make decisions about patients’ end-of-life care.”

But just as Obama eventually embraced the once-derisive term “Obamacare,” liberals are trying to take back the radioactive “death panels” phrase in the second round of health reform debate. At a town hall meeting Tuesday in Iowa, Grassley faced accusations that Obamacare repeal would be akin to a death panel, as it could end health coverage for millions of Americans.

“Over 20 million will lose coverage, and with all due respect, sir, you’re the man that talked about the death panels,” an Iowa farmer who relies on the health law argued at the event. “We're going to create one great big death panel in this country that people can’t afford to get insurance.”

Grassley helped the death panel myth take off. He was a legislator who told his constituents they were right to worry about the government “pulling the plug on Grandma.” But eight years later, he’s facing a quite different argument from his constituents: that ending the Affordable Care would pull the plug on them if they lose coverage.

Why has the death panel myth had such staying power? It arguably taps into fears of rationing, the idea that some people won’t get the medical care they need because the government doesn’t want to spend the money. This is not a uniquely American problem. Other countries, including Canada and Britain, run into the same issue. But the fear from Grassley’s constituents in 2009 and 2017 is essentially coming from the same place: a worry that those who need access to medical care may find themselves denied.

Kliff’s Notes: today’s top three health policy reads

“‘It saved my life': Talk of Obamacare repeal worries addicts”: “In Kentucky, which has been ravaged worse than almost any other state by fentanyl, heroin and other drugs, Tyler Witten went into rehab at Medicaid's expense after the state expanded the program under a provision of the act. Until then, he had been addicted to painkillers for more than a decade. "It saved my life," he said.” —Adam Beam and Carla K. Johnson, Associated Press

“McConnell-linked group to hardliners: It's repeal ​AND​ replace”: “The group's polling and ads are hitting at a critical time, with Freedom Caucus members and other hardliners saying they're mostly interested in repealing the law and then working out a replacement later. Outside conservative groups also worry that the longer Republicans try to agree on a replacement, the longer the repeal effort will take, giving Democrats and progressive groups time to mobilize against it.” —Jonathan Swan, Axios

“ObamaCare fix hinges on Medicaid clash in Senate”: “Sen. John Thune (R-SD) calls it the single thorniest issue of the entire debate. ‘You don’t want to punish or penalize states that didn’t expand [Medicaid], but the states that did expand are going to say, “We don’t want to get punished for expanding, either.” To me, that’s probably the thorniest and most difficult issue to resolve,’ said Thune, the chair of the Senate Republican Conference.” —Alexander Bolton, the Hill

Watch: Obamacare in Trump country