Two of President Donald Trump's fellow Republicans have joined four Democrats in demanding the White House provide more information about an executive order that has sown confusion among international organisations involved in family planning, AIDS treatment and other healthcare issues.
In one of his first actions as president, Trump signed an executive order reinstating the so-called Mexico City policy, known by critics as the "global gag" rule, which withholds US funding for international organisations that perform abortions or provide information about abortion.
Although other Republican presidents have also adopted the policy, Trump broadened the scope to all global health assistance, "which may encompass as much as fifteen times more federal funding than previous Republican administrations' versions of this policy", the six senators wrote in the letter, which was seen by Reuters.
The order withholds half a billion dollars or more in US funds, and aid groups said it was issued with so little guidance that they have been scrambling to figure out how to proceed.
In the letter, the senators said Trump's broader order now includes the President's Emergency Plan for AIDS Relief (PEPFAR) and all other global health programs funded through the Department of State, Agency for International Development and Department of Health and Human Services.
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PEPFAR, which enjoys broad bipartisan support in Congress, is the largest provider of AIDS-fighting medicine in the world, and has been credited with saving millions of lives.
Among other things, the senators asked if Trump's administration had conducted a cost-benefit assessment of the policy, whether it had determined how many lives might be saved or lost or whether it had researched how transmission of diseases such as HIV/AIDS and Zika might be affected.
Democratic Senator Jeanne Shaheen, who organised the letter and it was also signed by Republican Senators Susan Collins and Lisa Murkowski, Democrats Ben Cardin and Richard Blumenthal and Angus King, an independent who caucuses with Democrats.
