If we required that screen sharing tools were compatible with screen readers, we'd have to revamp many layers of abstractions. It would require changes to every operating system, every UI framework, every browser, and every screen sharing application. An alternative would be to throw a bunch of machine learning at the problem (to try to turn pixels back into meaning), but that would have a lot of broken corner cases. The issues would likely be as bad as auto-generated subtitles, which are generally not good enough to be considered ADA compliant.[1]
My guess is that if the law changed tomorrow and mandated that screen sharing tools accommodate the blind, we'd end up with no cross-platform screen sharing tools. Microsoft would make their Windows screen sharing. Apple would make their MacOS screen sharing. Google would make their ChromeOS screen sharing, and none of them would be interoperable. Also desktop Linux would be SOL.
1. UC Berkeley was forced to delete over 20,000 videos of lectures because their auto-generated subtitles weren't accurate enough: https://news.berkeley.edu/wp-content/uploads/2016/09/2016-08...