The Americans with Disabilities Act of 1990 or ADA () is a civil rights law that prohibits discrimination based on disability. It affords similar protections against discrimination to Americans with disabilities as the Civil Rights Act of 1964, which made discrimination based on race, religion, sex, national origin, and other characteristics illegal, and later sexual orientation and gender identity. In addition, unlike the Civil Rights Act, the ADA also requires covered employers to provide reasonable accommodations to employees with disabilities, and imposes accessibility requirements on public accommodations. In 1986, the National Council on Disability had recommended the enactment of an Americans with Disabilities Act and drafted the first version of the bill which was introduced in the House and Senate in 1988. A broad bipartisan coalition of legislators supported the ADA, while the bill was opposed by business interests (who argued the bill imposed costs on business) and conservative evangelicals (who opposed protection for individuals with HIV). The final version of the bill was signed into law on July 26, 1990, by President George H. W. Bush. It was later amended in 2008 and signed by President George W. Bush with changes effective as of January 1, 2009. Disabilities included ADA disabilities include both mental and physical medical conditions. A condition does not need to be severe or permanent to be a disability. Equal Employment Opportunity Commission regulations provide a list of conditions that should easily be concluded to be disabilities: amputation, attention deficit hyperactivity disorder (ADHD), autism, bipolar disorder, blindness, cancer, cerebral palsy, deafness, diabetes, epilepsy, human immunodeficiency virus (HIV), intellectual disability (formerly termed mental retardation), major depressive disorder, mobility impairments (often requiring a wheelchair), multiple sclerosis, muscular dystrophy, obsessive–compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and schizophrenia. Other mental or physical health conditions also may be disabilities, depending on what the individual's symptoms would be in the absence of "mitigating measures" (medication, therapy, assistive devices, or other means of restoring function), during an "active episode" of the condition (if the condition is episodic). Certain specific conditions that are widely considered anti-social, or tend to result in illegal activity, such as kleptomania, pedophilia, exhibitionism, voyeurism, etc. are excluded under the definition of "disability" in order to prevent abuse of the statute's purpose. Additionally, sexual orientation is no longer considered a disorder and is also excluded under the definition of "disability". However, in 2022, the United States Court of Appeals