A group of medical device industry trade associations are joining together to push the U.S. Congress toward repealing the medical device tax that’s been in abeyance since 2015.

MDMA, AdvaMed, MITA and a group of medical innovators, physician inventors, patient groups and more today sent a letter urging congressional leadership to permanently repeal the medical device excise tax, which put into effect for two years as a part of the Affordable Care Act.

The tax is a 2.3% levy on U.S. sales of prescribed medical devices. Congress has suspended the tax twice since it went into effect in 2013, with the second suspension slated to expire at the end of the year.

“The United States is the world leader in manufacturing life-saving and life-enhancing diagnostics and treatments within an industry that is an important engine for economic growth,” according to the letter. “Unfortunately, when the medical device tax was in effect, it had an adverse impact on R&D investment and job creation, jeopardizing the U.S. position as a global leader in medical device innovation.”

Several executives and leaders in the industry support the letter and urge for the tax repeal.

“This diverse community of voices urging Congress to fully and permanently repeal the medical device tax is yet another example of the growing coalition working together to ensure this tax on innovation never returns,” said Avalign Technologies CEO Jeff McCaulley, who is also chairman of MDMA. “Having fought against the medical device tax when it was first proposed in 2009, MDMA remains committed to working with members of Congress and all stakeholders to make sure that this disastrous policy never diverts precious resources away from the cures and therapies of tomorrow.”

“Congress needs to act now to stop a $20 billion tax on the medical technology industry from coming back at the end of the year,” added Stryker (NYSE:SYK) CEO & AdvaMed chairman Kevin Lobo. “This tax hurts innovation and the development of future treatments and cures. American patients and health care providers are counting on our industry to help improve and save lives and this tax is an obstacle to that mission.”

“We applaud the sweeping coalition of more than 600 signatories for leading the charge in urging lawmakers to repeal this economically harmful and innovation-stifling tax,” Bayer (ETR:BAYN) Radiology SVP, Americas Region & chair of MITA board of directors Dennis Durmis said. “By making their voices heard in the halls of Congress, innovators, patients, and job creators are letting our elected leaders know that the time has come to end permanently this punitive and burdensome excise tax.”

“This has been off the books now longer than it was on the books,” AdvaMed CEO Scott Whitaker said at a press conference at the annual AdvaMed Conference yesterday. “For four years, we’ve had this suspended. For four years, they haven’t paid for it. For four years, it’s been better for this industry. The likelihood of it coming back given what happened when it was on the books, I think, remains pretty low.”