Leading web developers have been pioneering accessibility and publishing standards since 1994. In 1999, the Web Accessibility Initiative (WAI) and the World Wide Web Consortium (W3C) created the Web Content Accessibility Guidelines (WCAG). In essence, the people who determine how the internet is written came together to advise web developers on how to make websites accessible not only to people with disabilities, but to all web users, including those with highly limited devices.
Web designers often design in such a way that does not allow the user to adjust font size or color. While they may be protecting their brand, they are also inhibiting some users. Many visually impaired need to use high contrast color settings or very large fonts to read a website. Don't design your website in a way that makes it impossible for them to do this. 
Courts have essentially taken three positions when approached with this issue. Some courts take the position that the ADA applies to all commercial sites because the law was meant to protect disabled individuals from having a more difficult time than able-bodied individuals from doing business. That is why the website Scribd was unable to get a case summarily dismissed and ended up settling.

You are correct, ADA defines an “employer” as any person who is 1) engaged in an industry affecting commerce; 2) employes 15 or more full-time employees each work day; and 3) for at least 20 or more calendar weeks in the year. In the context of physical spaces, ADA would not apply to companies with fewer than 15 employees. However, courts don’t seem to have come to a consensus on what digital compliance really should look like. Because websites can be accessed anywhere in the country, small business owners might potentially face lawsuits in unfavorable jurisdictions. If you are a small business owner, I would recommend consulting with an accessibility lawyer and ask what they recommend.

The ADA statute identifies who is a person with a disability, who has obligations under the ADA, general non-discrimination requirements and other basic obligations. It delegates fleshing out those obligations to federal agencies. The agencies issue regulations and design standards. The regulations have the details on the rights of people with disabilities and responsibilities of employers, state and local governments, transportation providers, businesses and non-profit organizations. The design standards specify how many entrances need to be accessible, how many toilet rooms and the design for those elements.  To know what the ADA requires, you need to read the law, regulations and design standards.  
I own a medical practice in California with 5 employees. Since I have under 15 employees am I exempt from needing to have my website comply with the ADA? I know that my physical practice is exempt from ADA policies regarding employment (under 15) but I don’t know if that extends to websites. My website is not an important part of my practice and I don’t really want to sink any funds into it if I don’t need to.
The fact that an ADA compliant website can increase your target audience by millions is just one reason to make your site more accessible. Another benefit is that not only will you get more customers, but those customers will also know how valuable they are to your business. After all, they might have gone to a few other websites that were not ADA compliant, disappointed each time that they couldn’t access the content, until they got to your website.

Additionally, in February 2018, Congress passed the ADA Education and Reform Act, a bill designed to make it harder for disabled Americans to sue businesses for discrimination. Republican lawmakers who wrote and passed the bill argue that the law will help curb “frivolous” lawsuits, while opponents have argued that this law will gut the ADA, essentially giving businesses little reason to follow the ADA guidelines at all.
This particular lawsuit amounted to nothing more than a shakedown for cash, as the current laws would make it difficult to win the suit in court (more about this later) but it prompted me to dive deeper into the issue of ADA compliance. Through my research, I discovered there are some new laws on the horizon that could make ADA compliance mandatory, which means web designers and digital marketers need to know how to prepare.

State and local governments will often post documents on their websites using Portable Document Format (PDF). But PDF documents, or those in other image based formats, are often not accessible to blind people who use screen readers and people with low vision who use text enlargement programs or different color and font settings to read computer displays.
The words in the tag should be more than a description. They should provide a text equivalent of the image. In other words, the tag should include the same meaningful information that other users obtain by looking at the image. In the example of the mayor’s picture, adding an “alt” tag with the words “Photograph of Mayor Jane Smith” provides a meaningful description.