Indiana’s Republican Gov. Mike Pence quietly signed a bill creating more regulations for abortion clinics while he was receiving heated criticism for a so-called religious liberty law and dealing with a serious public health crisis in the form of an HIV outbreak.

SB 546, sponsored by Sen. Mark Messmer (R-Jasper), amends state law to redefine an abortion clinic by excluding health-care providers that prescribe abortion-inducing drugs to fewer than five patients a year.

The bill was easily passed by the GOP-dominated Indiana legislature by votes of 41 to 8 in the senate and 77 to 22 in the house. Pence signed the bill into law on April 30.

The legislation was one of several targeted regulation of abortion providers (TRAP) bills introduced in state legislatures this year that single out abortion clinics and providers for regulations that are more stringent than those applied to any other medical facility.

The new law changes requirements for physicians who perform surgical abortions or prescribe abortion-inducing drugs, mandating that they provide reports to the state. It also changes specific details on a state form about the abortion or the abortion-inducing drug prescription.

Pence has signed a handful of anti-choice bills into law, including one banning private insurance coverage of most abortion care in the state. In 2013, Pence signed an omnibus abortion bill that created multiple abortion restrictions and clinic regulations. A federal court blocked the anti-choice law, pending the outcome of litigation.

Abortion is already highly regulated in Indiana, and access is severely limited. As of 2011, 93 percent of Indiana counties had no abortion clinic, and 61 percent of Indiana women lived in these counties, according to the Guttmacher Institute.

The new clinic regulations take effect July 1.