The law, which does not immediately go into effect, signals a new low for a long-troubled relationship between Israel and the U.N. Israel's international allies said they were deeply worried about its potential impact on Palestinians as the war's humanitarian toll is worsening.

Under the law, the U.N. agency for Palestinian refugees, or UNRWA, would be banned from conducting “any activity” or providing any service inside Israel. It risks collapsing the already fragile process for distributing aid in Gaza at a moment when Israel is under increased U.S. pressure to ramp up aid.

Israel has alleged that some of UNRWA’s thousands of staff members participated in the Hamas attacks last year that sparked the war in Gaza. It also has said hundreds of UNRWA staff have militant ties and that it has found Hamas military assets near or under the agency's facilities.

The agency fired nine employees after an investigation but denies it knowingly aids armed groups and says it acts quickly to purge any suspected militants from its ranks. Some of Israel's allegations prompted major international donors to cut funding to the agency, although some of it has been restored.

“The law that we passed now is not just another bill. It is a call for justice and a wake up call,” said lawmaker Boaz Bismuth, who co-sponsored the bill. “UNRWA is not an aid agency for refugees. It is an aid agency for Hamas.”

The vote passed 92-10 and followed a fiery debate between supporters of the law and its opponents, mostly members of Arab parliamentary parties.

A second bill severing diplomatic ties with UNRWA was also being voted on later Monday. Yuli Edelstein, a lawmaker who chaired committee discussions about the bills, said the bills were not meant to affect what he said was Israel's commitment to ensuring humanitarian aid reaches Gaza. But it was not clear how that would look once these bills take effect.

Together, the bills would effectively sever ties with the U.N. agency, strip it of legal immunities and restrict its ability to support Palestinians in east Jerusalem and the West Bank. The legislation does not include provisions for alternative organizations to oversee its work.

The changes would also be a serious blow to the agency and to Palestinians in Gaza. More than 1.9 million Palestinians are displaced from their homes and Gaza faces widespread shortages of food, water and medicine.

International aid groups and a handful of Israel’s Western allies, including the U.S., have voiced strong opposition.

U.S. State Department spokesperson Matthew Miller, speaking to reporters in Washington, said the administration was “deeply concerned” by the legislation. “There’s nobody that can replace them right now in the middle of the crisis,” he said.

UNRWA provides education, health care and other basic services to millions of Palestinian refugees across the region, including in the Israeli-occupied West Bank.

The bills would go into effect 60 to 90 days after Israel’s Foreign Ministry notifies the U.N., according to the spokesperson of lawmaker Dan Illouz, one of the co-sponsors of one of the bills.

“If it passes and if it’s implemented, it’s a disaster” said Juliette Touma, communications director for the agency. “UNRWA is the largest humanitarian organization in Gaza ... Who can do its job?”

Death toll in Gaza surpasses 43,000 as Israeli raids continue

With no end in sight to the war, officials in Gaza reported Monday that the death toll from the yearlong fighting surpassed 43,000. The Palestinian Health Ministry's count does not distinguish between civilians and combatants but it says more than half of the dead are women and children.

The rising death toll comes as Israel refocuses its offensive on Gaza's hard-hit north, including on a hospital where the military says militants were operating from.

Israeli forces raided the Kamal Adwan Hospital in northern Gaza on Friday. An Israeli military official, speaking Monday on condition of anonymity in keeping with regulations, said there was heavy fighting around the hospital, though not inside it, and that weapons were found inside the facility. The military said Monday the raid had ended.

Israel has raided several hospitals in Gaza over the course of the yearlong war, saying Hamas and other militants use them for military purposes. Palestinian medical officials deny those allegations and accuse the military of recklessly endangering civilians.

The Israeli military said it detained 100 suspected Hamas militants in the latest raid. The Israeli official said medical staff were detained and searched because some of the militants had disguised themselves as medics.

The World Health Organization accused Israel of detaining 44 male hospital staff. It was not immediately clear why there was a discrepancy in the figures. Palestinian medical officials said the hospital, which was treating some 200 patients, was heavily damaged in the raid.

The Israeli military has called on Palestinians to evacuate northern Gaza, where it has been waging a large offensive for more than three weeks. The official said the operation in the northern Gaza city of Jabaliya would last “several more weeks.”

The U.N. said earlier this month at least 400,000 people are in northern Gaza, an area that was an early target of Israel's retaliatory war. Hunger there is rampant as the amount of humanitarian aid reaching the north has plummeted over the past month.

The Israel-Hamas war began after militants from Hamas and other groups stormed into Israel, killing some 1,200 people — mostly civilians — and abducting 250 others. The war has roiled the Middle East, setting off fighting between Israel and Hezbollah as well as between Israel and Iran, archenemies who had long kept their conflict a shadow war but are now engaging in open fighting.

In Lebanon, successive Israeli airstrikes have pummeled the southern port city of Tyre following an evacuation order from the Israeli military for parts of the city, the state-run National News Agency reported Monday. No casualties were immediately reported.

International mediators renew efforts for a Gaza cease-fire

After collapsing in late summer, international mediators were trying to jump-start cease-fire efforts between Israel and Hamas. Israel said it would continue discussions on a halt in fighting after the head of the Mossad agency, David Barnea, returned from a meeting in Qatar with the head of the CIA, David Burns, and the Qatari prime minister.

Mediators are trying varying proposals to try to bring Israel and Hamas toward a deal. Egyptian President Abdel Fattah el-Sissi has suggested a two-day cease-fire in exchange for the release of four hostages.

Israel appeared responsive to the idea. One Israeli official said Israel was discussing the proposal both internally and with Egyptian officials. A second official said that Israeli Prime Minister Benjamin Netanyahu expressed enthusiasm for the proposal in a meeting with his Likud party on Monday.

Both officials spoke on condition of anonymity because they were not authorized to discuss internal deliberations about the proposal with the media.

Hamas has yet to formally respond to the plan and Hamas officials were not reachable for comment on Monday.