Israel also has missed some other deadlines and demands outlined in a Oct. 13 letter from Secretary of State Antony Blinken and Defense Secretary Lloyd Austin. The mid-November deadline -- following the U.S. election -- may serve as a final test of President Joe Biden 's willingness to check a close ally that has shrugged off repeated U.S. appeals to protect Palestinian civilians during the war against Hamas.

In their letter, Blinken and Austin demanded improvements to the deteriorating humanitarian condition in Gaza, saying that Israel must allow in a minimum of 350 trucks a day carrying desperately needed food and other supplies. By the end of October, an average of just 71 trucks a day were entering Gaza, according to the latest U.N. figures.

Blinken said the State Department and Pentagon were closely following Israel's response to the letter.

"There's been progress, but it's insufficient, and we're working on a daily basis to make sure Israel does what it must do to ensure that this assistance gets to people who need it inside of Gaza," Blinken told reporters.

"It's not enough to get trucks to Gaza. It's vital that what they bring with them can get distributed effectively inside of Gaza," he added.

Blinken and Austin's letter marked one of the toughest stands that the Biden administration has taken in a year of appeals and warnings to Israel to lessen the harm to Palestinian civilians.

Support for Israel is a bedrock issue for many Republican voters and some Democrats. That makes any Biden administration decision on restricting military funding to the U.S. ally a fraught one for the tight presidential race between Vice President Kamala Harris and former President Donald Trump.

In hard-hit north Gaza in particular, an escalated Israeli military campaign and restrictions on aid has kept all food and other care from reaching populated areas since mid-October, aid organizations say. It could set the stage for famine in coming weeks or months, international monitors say.

And despite U.S. objections, Israeli lawmakers this week voted to effectively ban the U.N. agency for Palestinian refugees, known as UNRWA. Governments worldwide, the U.N. and aid organizations say cutting off UNRWA would shatter the aid networks struggling to get food and other supplies to people in Gaza.

"Catastrophic," Amber Alayyan, a medical program manager for Gaza at Doctors Without Borders, said of the move.

Humanitarian officials are deeply skeptical Israel will significantly improve assistance to Gaza's civilians even with the U.S. warning -- or that the Biden administration will do anything if it doesn't.

At this point in the war, "neither of those has happened," said Scott Paul, an associate director of the Oxfam humanitarian organization.

"Over and over and again, we've been told" by Biden administration officials "that there are processes to evaluate the situation on the ground" in Gaza "and some movement's been made to implement U.S. law, and time and again that has not happened," Paul said.

Before the war, an average of 500 trucks daily brought aid into the territory. Relief groups have said that's the minimum needed for Gaza's 2.3 million people, most of whom have since been uprooted from their homes, often multiple times.

There has never been a month where Israel came close to meeting that figure since the conflict began, peaking in April at 225 trucks a day, according to Israeli government figures.

By the time Blinken and Austin sent their letter this month, concerns were rising that aid restrictions were starving civilians. The number of aid trucks that Israel has allowed into Gaza has plunged since last spring and summer, falling to a daily average of just 13 a day by the beginning of October, according to U.N. figures.

By the end of the month, it rose to an average of 71 trucks a day, the U.N. figures show.

Once supplies get to Gaza, groups still face obstacles distributing the aid to warehouses and then to people in need, organizations and the State Department said this week. That includes slow Israeli processing, Israeli restrictions on shipments, lawlessness and other obstacles, aid groups said.

Data from COGAT, the Israeli military body in charge of humanitarian aid to Gaza, shows aid has fallen to under a third of its levels in September and August. In September, 87,446 tons of aid entered the Gaza Strip. In October, 26,399 tons got in.

Elad Goren, a senior COGAT official, said last week that aid delivery and distribution in the north has been mainly confined to Gaza City.

When asked why aid was not being delivered to other parts of the north -- like Jabaliya, a crowded urban refugee camp where Israel is staging an offensive -- he said the population there was being evacuated and those who remained had "enough assistance" from previous months.

In other areas like Beit Hanoun and Beit Lahiya, Goren claimed falsely that there was "no population" left there.

COGAT declined to comment on the standard in the U.S. letter. It said it was complying with government directives on aid to Gaza. Israel's U.N. Ambassador Danny Danon blamed Hamas for plundering aid.

Paul of Oxfam said no aid at all was reaching populated areas in northern Gaza and only small amounts getting to Gaza City.

"No way" has Israel made progress in getting humanitarian support to the hundreds of thousands of people in north Gaza in particular since the U.S. ultimatum, said Alayyan of Doctors Without Borders.

Israel's government appeared to blow past another deadline set in Austin and Blinken's letter. It called for Israel to set up a senior-level channel for U.S. officials to raise concerns about reported harm to Palestinian civilians and hold a first meeting by the end of October.

No such channel -- requested repeatedly by the U.S. during the war -- had been created by the final day of the month.

The U.S. is by far the biggest provider of arms and other military aid to Israel, including nearly $18 billion during the war in Gaza, according to a study for Brown University's Costs of War project.

The Biden administration paused a planned shipment of 2,000-pound bombs to Israel last spring, citing concerns for civilians in an Israeli offensive.

In a formal review in May, the administration concluded that Israel's use of U.S.-provided weapons in Gaza likely violated international humanitarian law but said wartime conditions prevented officials from determining that for certain in specific strikes.

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AP writers Matthew Lee in Washington, Julia Frankel in Jerusalem and Edith M. Lederer at the United Nations contributed.