Washington DC - The US warned Israel on the possibility of withholding some assistance barring improvements in aid delivery to Palestinians in Gaza, the State Department said Tuesday.

In a letter sent Sunday, Secretary of State Antony Blinken and Defense Secretary Lloyd Austin made "clear to the government of Israel that there are changes that they need to make again to see that the level of assistance making it into Gaza comes back up from the very, very low levels that it is at today," State Department spokesman Matthew Miller told reporters.

The letter pointed to US law that requires that "recipients of US military assistance do not arbitrarily deny or impede the provisioning of US humanitarian assistance."

"Our hope is that Israel will make changes that we have outlined and that we have recommended, and as a result of those changes will be a dramatic increase in humanitarian assistance."

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The letter, weeks before a US election, comes a year into Israel's brutal assault on Gaza in which President Joe Biden has repeatedly voiced concern about the lack of assistance and high civilian casualties but only once is known to have blocked a shipment in the billions of dollars of US aid to Israel.

Miller denied any link to the US election. The letter called for action within 30 days, which would fall after voting ends.

"We didn't think it was appropriate to send a letter and just say this has to happen overnight," Miller said.

He pointed to Israel sending assistance through the Erez crossing into Gaza on Monday, a day after Blinken sent the letter.

"We very much want to see changes not wait for 30 days but happen immediately," he said.