Tensions rose sharply between the United States and Israel on Monday, as Tel Aviv abruptly canceled a high-level visit to Washington after the Biden administration’s decision to permit passage of a United Nations resolution demanding an unconditional halt to fighting in Gaza.

The administration, facing mounting global pressure over U.S. support for Israel’s military operation against Hamas militants, abstained in a vote on a U.N. Security Council measure calling for an immediate cease-fire, the first of its kind that Washington has not vetoed.

The government of Prime Minister Benjamin Netanyahu responded by calling off this week’s planned visit by a senior delegation whom U.S. officials had invited to discuss plans for an expected operation into the southern city of Rafah. Israeli officials have described it as a necessary final step in disabling Hamas, but critics have warned that such a push would be a perilous blow to civilians trapped amid the fighting and beset by hunger and disease.

Monday’s episode underscores the extent to which Israel’s campaign against Hamas has plunged historic allies into crisis and worsened underlying divisions between President Joe Biden and Netanyahu’s far-right government, which has rejected with increasing defiance the long-standing U.S. goal of a securing a two-state solution to the long-running Palestinian conflict.

The U.S. abstention on the resolution, which also called for the “immediate and unconditional release of all hostages” held in Gaza, marked a significant shift for the administration. Since the beginning of hostilities last fall, the United States has repeatedly provided diplomatic cover for Israel at the United Nations, where Israeli officials have argued that a cease-fire would allow Hamas time to regroup.

Conditions in the Palestinian enclave have become catastrophic — a crisis aid officials describe as unparalleled in decades. As the United Nations warns of imminent famine, local health authorities say that more than 30,000 people have died since Israel began its military response to Hamas’s cross-border attack Oct. 7 that killed at least 1,200 and resulted in the taking of 253 hostages.

Aaron David Miller, a veteran U.S. diplomat who is a senior fellow at the Carnegie Endowment for International Peace, said the U.S. abstention would diminish Washington’s leverage over Israel and make it harder to secure its goals of enabling greater entry of aid and protections for civilians.

Analysts say Netanyahu’s bellicose rhetoric regarding a potential Rafah operation — and now, potentially, his decision to lash out at Washington — is aimed in large part at his domestic constituency. Biden has his own political concerns as he accelerates his campaign to secure a second term and attempts to manage growing dissatisfaction among Democrats with his handling of the war.

“It’s part of a new sort of dance routine, perhaps by both sides,” Miller said.

White House National Security Council spokesman John Kirby said the decision to cancel the Israeli delegation’s visit had “perplexed” top U.S. officials. He also downplayed the significance of Monday’s vote at the U.N. Security Council, where the new measure passed 14-0.

“There is no reason for this to be seen as some sort of escalation,” Kirby told reporters. “Nothing has changed about our policy. We still want to see a cease-fire. We still want to get all hostages out. And we still want to see more humanitarian assistance get in to the people of Gaza.”

In a March 18 call, Biden had asked Netanyahu to send a senior interagency team that could listen to U.S. concerns about Israel’s planned push into Rafah, where nearly 1.5 million displaced Palestinians are sheltering.

Despite the delegation’s cancellation, previously scheduled talks went ahead Monday with Israeli Defense Minister Yoav Gallant, who met with Secretary of State Antony Blinken and national security adviser Jake Sullivan. A meeting with Defense Secretary Lloyd Austin is expected Tuesday.

The State Department said that Blinken, in his meeting with Gallant, emphasized “that alternatives exist to a major ground invasion that would both better ensure Israel’s security and protect Palestinian civilians.”

Sullivan said he conveyed to Gallant Biden’s “ironclad” support for Israel’s right to defend itself against Hamas and other threats, including Iran. In a social media post, Sullivan said that Gallant committed to taking additional steps to mitigate the deepening humanitarian crisis in Gaza.

The Israeli government said the discussion with Sullivan was focused on efforts to free Israeli hostages and to defeat Hamas.

“We have no moral right to stop the war while there are still hostages held in Gaza,” Gallant said before those talks, according to an Israeli government statement.

The Gaza crisis has left the United States, which has sent more than 100 weapons deliveries to Israel since the war began, increasingly isolated on the world stage.

That has been particularly apparent at the United Nations, where the United States has vetoed three previous cease-fire resolutions and failed to secure passage of its own that tied a stop to the fighting to the release of hostages. Monday’s measure, supported by Russia and China, separated the two provisions as independent demands.

The resolution says the cease-fire should start immediately and last throughout Ramadan, Islam’s holy month of fasting, which began earlier this month, and lay the groundwork for a sustainable end to the war. In explaining the abstention, U.S. Ambassador to the United Nations Linda Thomas-Greenfield said the United States “did not agree with everything in the resolution.” While “we fully support some of the objectives,” she said, “we believe it was important to speak out and make clear that any cease-fire must come with the release of all hostages.”

On Sunday, Vice President Kamala Harris told ABC News’s “This Week” that any military operation in Rafah “would be a huge mistake.” Asked whether there would be “consequences” from the United States for an Israeli operation in Rafah, she said, “I am ruling out nothing.”

Netanyahu, addressing the nation late Sunday on the Jewish holiday of Purim, said that “it is impossible to defeat the sheer evil [of Hamas] by leaving it intact in Rafah. … We will enter Rafah and achieve total victory.”

Despite mounting public criticism from U.S. leaders, Biden administration officials so far appear unwilling to use the most direct leverage they have, which would involve imposing conditions on the supply of U.S. military equipment to Israel.

During a visit to Tel Aviv on Friday, Blinken was asked repeatedly whether the United States might halt or slow aid to Israel if it invades Rafah or if the conflict continues, and each time he said he would not speculate about hypotheticals.

While U.S. officials acknowledge that Israel has taken some steps to better facilitate the entry of aid into Gaza, they say much more must be done and add that Israel has not yet presented a concrete plan for its Rafah operation.

The administration had intended to discuss the operation this week during the Israeli delegation’s planned visit and share advice from top U.S. counterterrorism experts based on experiences in Iraq and Afghanistan and in the campaign against the Islamic State. It’s now unclear how and when that guidance will be communicated.

Fighting raged for a seventh day on Monday in northern Gaza, where the hunger crisis is most acute, as the Israel Defense Forces said it was continuing operations in the area of al-Shifa Hospital.

The IDF has cast that mission as advancing its goal of destroying Hamas, reporting that more than 150 people the IDF said were terrorists have been killed and that hundreds of suspects have been detained since the operation began. In a statement, the IDF said that fighting was taking place within the hospital buildings and that “many weapons” had been discovered inside the maternity ward. The claims could not immediately be verified.

But global health officials have voiced horror at the conditions faced by medics and patients trapped inside the facility. Citing an unidentified doctor, Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said Friday that 50 health-care workers and 143 patients were trapped in one building with extremely limited food and water and a single nonfunctional toilet. He reported that many of the patients were in critical condition and lying on the floor.

Hossam, a 28-year-old man trapped with dozens of relatives inside an apartment building near the hospital, said the sounds of fighting were constant. He asked that his surname be withheld citing concerns for his safety.

From their building high above the hospital, Hossam reported seeing tanks in the courtyard of the medical complex, “while the bulldozers carry out continuous sweeping operations of the streets and neighboring houses.”

While Israel has proposed moving displaced families in the southern city of Rafah to “humanitarian islands” in other parts of the enclave, it is unclear how that would work in practice. Fighting between the Israeli army and Hamas militants has continued to rage in areas that were once designated as safe zones. Civilians, most of them displaced multiple times, say there is no place left in Gaza that is truly safe.

Loveluck and Birnbaum reported from London. Shane Harris and John Hudson in Washington, Hajar Harb and Annabelle Timsit in London, Lior Soroka in Tel Aviv, Rachel Pannett in Sydney, and Sarah Dadouch in Beirut contributed to this report.

previous coverage

• Israeli defense chief to visit Washington as tensions rise over Gaza war
• In Jerusalem and West Bank, Ramadan marred by violence and loss