www.medicaid.gov: Accessibility — week 2026-W28

Automated Accessibility Conformance Report (OpenACR): Download ACR. Machine-readable; compatible with GSA OpenACR tooling. Automated tools find ~⅓ of real barriers — supplement with manual AT testing.

Training priorities

Top WCAG success criteria by pages affected this week. Use these to focus team training on the highest-impact issues.

SC	Criterion	Pages	Rules
1.4.6	WCAG 1.4.6	4198	1
2.5.5	WCAG 2.5.5	4198	1
1.3.1	Info and Relationships (semantic structure)	2169	2
4.1.2	Name, Role, Value (ARIA)	2007	5
1.4.8	WCAG 1.4.8	1612	3

Next 10 actions

Clusters are fingerprinted by normalized selector path + rule id + snippet shape. Rank score = (severity weight × pages affected) / distinct components for the rule. This supersedes the template threshold heuristic while still surfacing it as a validation signal.

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
Page should contain a level-one heading · unattributed component Fix one place, resolve ~5237 finding(s) on 5237 page(s). XPath / selector: `html` `<html class="no-js" lang="en">`	Serious	5237	Requires manual testing.	See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~5226 finding(s) on 5226 page(s). XPath / selector: `html` `<html class="no-js" lang="en">`	Serious	5226	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Certain ARIA roles must contain particular children · unattributed component Fix one place, resolve ~1311 finding(s) on 1311 page(s). XPath / selector: `.nav` `<div class="nav nav-tabs nav-justified" role="tablist">`	Critical	1311	Without vision, Limited vision, Limited cognitive, language, or learning ability	Add the child roles this container role requires (e.g. a list needs listitem children).	pages (CSV)	Decision Assigned to Notes
First focusable element is link to main content · unattributed component Fix one place, resolve ~2621 finding(s) on 2621 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	2621	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87	pages (CSV)	Decision Assigned to Notes
Form field label is visible · unattributed component Fix one place, resolve ~2608 finding(s) on 2608 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	2608	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~1325 finding(s) on 1325 page(s). XPath / selector: `<a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">`	Moderate	1325	Without vision, Without speech	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14	pages (CSV)	Decision Assigned to Notes
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~5249 finding(s) on 5249 page(s). XPath / selector: `.small` `<div class="small p-1">`	Serious	5249	Requires manual testing.	Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.	pages (CSV)	Decision Assigned to Notes
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~5239 finding(s) on 5239 page(s). XPath / selector: `.justify-content-between` `<div class="d-flex justify-content-between m-2 mb-2">`	Serious	5239	Requires manual testing.	Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.	pages (CSV)	Decision Assigned to Notes
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~5236 finding(s) on 5236 page(s). XPath / selector: `.font-weight-bold` `<p class="font-weight-bold m-0 mr-1">Version:</p>`	Serious	5236	Requires manual testing.	Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~2607 finding(s) on 2607 page(s). XPath / selector: `text: " An official website of the United States government "`	Moderate	2607	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes

Bug reports

16 issue type(s) are shown by default out of 40 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 4 critical, 8 serious, 27 moderate, 1 minor. By WCAG category: 12 WCAG 2.0 A, 1 WCAG 2.0 AA, 1 WCAG 2.1 A, 1 WCAG 2.2 AA, 5 WCAG 2.x AAA, 10 Best Practice, 10 Undetermined. Ordered by severity, key-page impact, WCAG level, and prevalence. Following accessibility bug-reporting best practices. Download: Markdown · JSON (full archive) · JSON (AI diagnostic) · CSV (all findings) · Priority pages CSV · Priority pages JSON.

Automated testing does not establish full WCAG conformance. Findings in the verification lane require manual testing before they are treated as confirmed failures.

Default view shows 16 prioritized issue type(s); 24 more are available if you switch to "Show everything".

3 finding(s) marked "possible duplicate" — Alfa and axe-core both flagged the same WCAG SC on overlapping pages. If they target the same element, the axe-core report is authoritative. Filter the CSV by possible_duplicate_of to see these. Two engines flagging the same barrier reduces the chance of a false positive.

Findings needing review

These findings need manual verification before they can be treated as confirmed failures. Obligation remains visible for each finding.

Critical axe aria-allowed-attr WCAG 2.0 A Elements must only use supported ARIA attributes (WCAG 4.1.2) 1311/8593 pages · 6390 instances Likely template

Bug ID: VS-f236911d
Pattern ID: VS-1467ea8a
Combined ID: VS-f236911d (pattern VS-1467ea8a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Elements must only use supported ARIA attributes [aria-allowed-attr]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
XPath / selector: a[href$="#overview"]
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a class="nav-item nav-link active" href="#overview" role="link" aria-selected="true" aria-controls="overview" data-toggle="tab">Overview</a>

Description

Elements must only use supported ARIA attributes. Detected by axe-core rule aria-allowed-attr on 1311 of 8593 scanned pages (6390 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111.
Locate the element: a[href$="#overview"]
Confirm the axe-core finding for rule aria-allowed-attr against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

…and more — all 1311 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Remove ARIA attributes that aren't allowed on this role/element.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-attr?application=axeAPI

Triage status Notes

Critical axe aria-required-children WCAG 2.0 A Certain ARIA roles must contain particular children (WCAG 1.3.1) 1311/8593 pages · 1311 instances Likely template

Bug ID: VS-d2b8a747
Pattern ID: VS-9429bb8d
Combined ID: VS-d2b8a747 (pattern VS-9429bb8d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: axe-core — Certain ARIA roles must contain particular children [aria-required-children]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
XPath / selector: .nav
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div class="nav nav-tabs nav-justified" role="tablist">

Description

Certain ARIA roles must contain particular children. Detected by axe-core rule aria-required-children on 1311 of 8593 scanned pages (1311 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111.
Locate the element: .nav
Confirm the axe-core finding for rule aria-required-children against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 1311 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Add the child roles this container role requires (e.g. a list needs listitem children).

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-required-children?application=axeAPI

Triage status Notes

Serious axe aria-input-field-name WCAG 2.0 A ARIA input fields must have an accessible name (WCAG 4.1.2) 467/8593 pages · 999 instances Likely template

Bug ID: VS-b77e2914
Pattern ID: VS-0841abc2
Combined ID: VS-b77e2914 (pattern VS-0841abc2) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — ARIA input fields must have an accessible name [aria-input-field-name]
Example URL: https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=
XPath / selector: span[data-select2-id="select2-data-1-2krc"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false" tabindex="-1" aria-disabled="false">

Description

ARIA input fields must have an accessible name. Detected by axe-core rule aria-input-field-name on 467 of 8593 scanned pages (999 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=.
Locate the element: span[data-select2-id="select2-data-1-2krc"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
Confirm the axe-core finding for rule aria-input-field-name against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

…and more — all 467 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-input-field-name?application=axeAPI

Triage status Notes

Critical axe select-name WCAG 2.0 A Select element must have an accessible name (WCAG 4.1.2) 2/8593 pages · 2 instances Likely content

Bug ID: VS-bfdec3d2
Pattern ID: VS-fab92378
Combined ID: VS-bfdec3d2 (pattern VS-fab92378) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Select element must have an accessible name [select-name]
Example URL: https://www.medicaid.gov/tmsis/dataguide/t-msis-coding-blog
XPath / selector: #items-per-page
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<select id="items-per-page" class="form-select">
                                <option value="10">10</option>
                                <option value="25">25</option>

Description

Select element must have an accessible name. Detected by axe-core rule select-name on 2 of 8593 scanned pages (2 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/t-msis-coding-blog.
Locate the element: #items-per-page
Confirm the axe-core finding for rule select-name against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give the <select> an accessible name via a <label> or aria-label.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/select-name?application=axeAPI

Triage status Notes

Serious axe aria-prohibited-attr WCAG 2.0 A Elements must only use permitted ARIA attributes (WCAG 4.1.2) 2/8593 pages · 2 instances Likely content

Bug ID: VS-5f86aa07
Pattern ID: VS-ebb1c464
Combined ID: VS-5f86aa07 (pattern VS-ebb1c464) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — Elements must only use permitted ARIA attributes [aria-prohibited-attr]
Example URL: http://medicaid.gov/about-us/where-can-people-get-help-medicaid-chip
XPath / selector: #map-svg-map-1741285150489
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div id="map-svg-map-1741285150489" class="map-container" aria-disabled="true" aria-label="State Map Image. Keyboard navigating users can use dropdown to select state." style="position: relative; widt

Description

Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 2 of 8593 scanned pages (2 instances).

Steps to reproduce

Open http://medicaid.gov/about-us/where-can-people-get-help-medicaid-chip.
Locate the element: #map-svg-map-1741285150489
Confirm the axe-core finding for rule aria-prohibited-attr against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-prohibited-attr?application=axeAPI

Triage status Notes

Critical axe image-alt WCAG 2.0 A Images must have alternative text (WCAG 1.1.1) 1/8593 pages · 1 instances Likely content

Bug ID: VS-38918f70
Pattern ID: VS-9074b4dd
Combined ID: VS-38918f70 (pattern VS-9074b4dd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: axe-core — Images must have alternative text [image-alt]
Example URL: https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
XPath / selector: p:nth-child(1) > a > img
History: first seen 2026-W24, last seen 2026-W28 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<img src="/media/file/monitor-eval-1115-demonstrations0.png/">

Description

Images must have alternative text. Detected by axe-core rule image-alt on 1 of 8593 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation.
Locate the element: p:nth-child(1) > a > img
Confirm the axe-core finding for rule image-alt against WCAG 1.1.1 Non-text Content.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give every <img> a meaningful alt attribute. Use alt="" only for decorative images so screen readers skip them.

Drupal tip: In Drupal's Media Library, fill the "Alternative text" field when uploading or editing an image. For images in body fields, the CKEditor "Image Properties" dialog includes an Alt Text field.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/image-alt?application=axeAPI

Triage status Notes

Serious axe color-contrast WCAG 2.0 AA Elements must meet minimum color contrast ratio thresholds (WCAG 1.4.3) 1/8593 pages · 2 instances Likely content

Bug ID: VS-a9773a65
Pattern ID: VS-be8d563e
Combined ID: VS-a9773a65 (pattern VS-be8d563e) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: axe-core — Elements must meet minimum color contrast ratio thresholds [color-contrast]
Example URL: http://medicaid.gov/chip/reports-evaluations
XPath / selector: .helpful-box-gray-sm > p > span
History: first seen 2026-W24, last seen 2026-W28 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<span id="nav-icon">🛈</span>

Description

Elements must meet minimum color contrast ratio thresholds. Detected by axe-core rule color-contrast on 1 of 8593 scanned pages (2 instances).

Steps to reproduce

Open http://medicaid.gov/chip/reports-evaluations.
Locate the element: .helpful-box-gray-sm > p > span
Confirm the axe-core finding for rule color-contrast against WCAG 1.4.3 Contrast (Minimum).

Impact

Affects Limited vision (2.4%), Without color perception (4.5%).

Limited vision — 2.4% of population
Without color perception — 4.5% of population

Affected pages

/chip/reports-evaluations

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Increase the contrast between text and its background to at least 4.5:1 (3:1 for large text). Check both light and dark modes.

Drupal tip: Check your Drupal theme's base CSS. Themes like Olivero and Bartik have contrast issues in default color schemes — override failing color pairs in your subtheme's style.css.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/color-contrast?application=axeAPI

Triage status Notes

Serious axe link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 1/8593 pages · 1 instances Likely content

Bug ID: VS-f1a54936
Pattern ID: VS-e9fe47ac
Combined ID: VS-f1a54936 (pattern VS-e9fe47ac) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: axe-core — Links must have discernible text [link-name]
Example URL: https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
XPath / selector: p:nth-child(1) > a
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf"><img src="/media/file/monitor-eval-1115-demonstrations0.png/"></a>

Description

Links must have discernible text. Detected by axe-core rule link-name on 1 of 8593 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation.
Locate the element: p:nth-child(1) > a
Confirm the axe-core finding for rule link-name against WCAG 2.4.4 Link Purpose (In Context).

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give the link discernible text. Avoid empty links and icon-only links without an aria-label.

Drupal tip: "Read more" links from Drupal Views should use the "Link text" rewrite field to add context, or add aria-label via the Views rewrite output.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/link-name?application=axeAPI

Triage status Notes

Serious axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 5249/8593 pages · 23788 instances Likely template

Bug ID: VS-02a6a6df
Pattern ID: VS-f18df681
Combined ID: VS-02a6a6df (pattern VS-f18df681) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — All page content should be contained by landmarks [region]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117
XPath / selector: .small
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<div class="small p-1">

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 5249 of 8593 scanned pages (23788 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
Locate the element: .small
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 5249 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region.

Drupal tip: Use Drupal's region system (header, navigation, main, sidebar, footer) and map each to an HTML5 landmark element in your theme's page.html.twig.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/region?application=axeAPI

Triage status Notes

Serious axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 5237/8593 pages · 5237 instances Likely template

Bug ID: VS-9605e6ed
Pattern ID: VS-fa44f293
Combined ID: VS-9605e6ed (pattern VS-fa44f293) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Page should contain a level-one heading [page-has-heading-one]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html class="no-js" lang="en">

Description

Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 5237 of 8593 scanned pages (5237 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
Locate the element: html
Confirm the axe-core finding for rule page-has-heading-one.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 5237 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI

Triage status Notes

Serious axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 5226/8593 pages · 5226 instances Likely template

Bug ID: VS-37bb2542
Pattern ID: VS-d5d82446
Combined ID: VS-37bb2542 (pattern VS-d5d82446) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should have one main landmark [landmark-one-main]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<html class="no-js" lang="en">

Description

Document should have one main landmark. Detected by axe-core rule landmark-one-main on 5226 of 8593 scanned pages (5226 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
Locate the element: html
Confirm the axe-core finding for rule landmark-one-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 5226 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Each page should have exactly one <main> landmark.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-one-main?application=axeAPI

Triage status Notes

Serious axe label-title-only Best Practice Form elements should have a visible label (WCAG criterion undetermined) 11/8593 pages · 46 instances Likely template

Bug ID: VS-4f56b347
Pattern ID: VS-33841929
Combined ID: VS-4f56b347 (pattern VS-33841929) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Form elements should have a visible label [label-title-only]
Example URL: http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
XPath / selector: select[aria-labelledby="filter-th-87386-0"]
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<select aria-labelledby="filter-th-87386-0" class="usa-select height-1" data-col-index="0" title="Filter by Type">
          <option value="">All</option>
        <option value="Federal Upper Limit">F

Description

Form elements should have a visible label. Detected by axe-core rule label-title-only on 11 of 8593 scanned pages (46 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing.
Locate the element: select[aria-labelledby="filter-th-87386-0"]
Confirm the axe-core finding for rule label-title-only.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/label-title-only?application=axeAPI

Triage status Notes

Moderate alfa sia-r14 WCAG 2.1 A Accessible name of link or button matches visible label (WCAG 2.5.3) 1325/8593 pages · 1325 instances Likely template

Bug ID: VS-256d2834
Pattern ID: VS-f7dba940
Combined ID: VS-256d2834 (pattern VS-f7dba940) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.1 A
Obligation: required
Handling: review
WCAG SC: 2.5.3 Label in Name (Level A, WCAG 2.1)
Rule: Siteimprove Alfa — Accessible name of link or button matches visible label [sia-r14]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
XPath / selector: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 1325 of 8593 scanned pages (1325 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
Locate the element: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
Confirm the Siteimprove Alfa finding for rule sia-r14 against WCAG 2.5.3 Label in Name.

Impact

Affects Without vision (1.0%), Without speech (0.5%).

Without vision — 1.0% of population
Without speech — 0.5% of population

Affected pages

…and more — all 1325 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14

Triage status Notes

Moderate alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 858/8593 pages · 890 instances · possible duplicate Likely template

Bug ID: VS-f2fff492
Pattern ID: VS-d6097011
Combined ID: VS-f2fff492 (pattern VS-d6097011) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.3.1 Info and Relationships (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Presentational children of an element are not focusable [sia-r68]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
XPath / selector: <div class="nav nav-tabs nav-justified" role="tablist">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-d2b8a747 (pattern VS-9429bb8d). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Presentational children of an element are not focusable. Detected by Siteimprove Alfa rule sia-r68 on 858 of 8593 scanned pages (890 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111.
Locate the element: <div class="nav nav-tabs nav-justified" role="tablist">
Confirm the Siteimprove Alfa finding for rule sia-r68 against WCAG 1.3.1 Info and Relationships.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

…and more — all 858 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r68

Triage status Notes

Moderate alfa sia-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 226/8593 pages · 483 instances Likely template

Bug ID: VS-b5fa69fb
Pattern ID: VS-179ad9b3
Combined ID: VS-b5fa69fb (pattern VS-179ad9b3) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.2 AA
Obligation: required
Handling: review
WCAG SC: 2.5.8 Target Size (Minimum) (Level AA, WCAG 2.2)
Rule: Siteimprove Alfa — Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]
Example URL: https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=
XPath / selector: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 226 of 8593 scanned pages (483 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=.
Locate the element: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
Confirm the Siteimprove Alfa finding for rule sia-r113 against WCAG 2.5.8 Target Size (Minimum).

Impact

Affects Limited manipulation/strength (13.0%), Limited reach (2.0%), Limited vision (2.4%).

Limited manipulation/strength — 13.0% of population
Limited reach — 2.0% of population
Limited vision — 2.4% of population

Affected pages

…and more — all 226 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r113

Triage status Notes

Moderate alfa sia-r8 WCAG 2.0 A Form field has accessible name (WCAG 4.1.2) 225/8593 pages · 482 instances Likely template

Bug ID: VS-fac38788
Pattern ID: VS-a48e6078
Combined ID: VS-fac38788 (pattern VS-a48e6078) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Form field has accessible name [sia-r8]
Example URL: https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=
XPath / selector: <span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 225 of 8593 scanned pages (482 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=696&page=29&q=.
Locate the element: <span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">
Confirm the Siteimprove Alfa finding for rule sia-r8 against WCAG 4.1.2 Name, Role, Value.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited manipulation/strength (13.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited manipulation/strength — 13.0% of population

Affected pages

…and more — all 225 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Associate the form field with a label.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r8

Triage status Notes

Moderate alfa sia-r66 WCAG 2.x AAA Text has enhanced contrast (WCAG 1.4.6) 4198/8593 pages · 94539 instances Likely template

Bug ID: VS-9db52072
Pattern ID: VS-646b1e0b
Combined ID: VS-9db52072 (pattern VS-646b1e0b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.6 Contrast (Enhanced) (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has enhanced contrast [sia-r66]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
XPath / selector: text: "Here's how you know "
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 4198 of 8593 scanned pages (94539 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
Locate the element: text: "Here's how you know "
Confirm the Siteimprove Alfa finding for rule sia-r66 against WCAG 1.4.6 Contrast (Enhanced).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 4198 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Increase text contrast to meet WCAG AAA (7:1).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r66

Triage status Notes

Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 4198/8593 pages · 58021 instances Likely template

Bug ID: VS-5c4e71f7
Pattern ID: VS-cb53cc4d
Combined ID: VS-5c4e71f7 (pattern VS-cb53cc4d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 2.5.5 Target Size (Enhanced) (Level AAA, WCAG 2.1)
Rule: Siteimprove Alfa — Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
XPath / selector: <button class="btn btn-outline-primary dropdown-toggle py-1 px-2" type="button" id="dropdownMenuButton" data-toggle="dropdown">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 4198 of 8593 scanned pages (58021 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
Locate the element: <button class="btn btn-outline-primary dropdown-toggle py-1 px-2" type="button" id="dropdownMenuButton" data-toggle="dropdown">
Confirm the Siteimprove Alfa finding for rule sia-r111 against WCAG 2.5.5 Target Size (Enhanced).

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 4198 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r111

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 4191/8593 pages · 104738 instances Likely template

Bug ID: VS-1257640a
Pattern ID: VS-c18be945
Combined ID: VS-1257640a (pattern VS-c18be945) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Scrolling content can be accessed by keyboard [sia-r57]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
XPath / selector: text: " An official website of the United States government "
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 4191 of 8593 scanned pages (104738 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
Locate the element: text: " An official website of the United States government "
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 4191 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57

Triage status Notes

Moderate alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 2621/8593 pages · 2621 instances Likely template

Bug ID: VS-0f599655
Pattern ID: VS-aa242c2d
Combined ID: VS-0f599655 (pattern VS-aa242c2d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — First focusable element is link to main content [sia-r87]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 2621 of 8593 scanned pages (2621 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r87.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 2621 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 2608/8593 pages · 2608 instances Likely template

Bug ID: VS-5b974334
Pattern ID: VS-7118fead
Combined ID: VS-5b974334 (pattern VS-7118fead) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Form field label is visible [sia-r61]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 2608 of 8593 scanned pages (2608 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 2608 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61

Triage status Notes

Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 1590/8593 pages · 10964 instances Likely template

Bug ID: VS-1f7646d5
Pattern ID: VS-2208081b
Combined ID: VS-1f7646d5 (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110
XPath / selector: <p class="usa-footer__contact-info margin-bottom-0">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 1590 of 8593 scanned pages (10964 instances).

Steps to reproduce

Open https://www.medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A856&f%5B1%5D=fpg_topics_facet%3A1021&f%5B2%5D=fpg_topics_facet%3A1471&f%5B3%5D=fpg_topics_facet%3A2696&f%5B4%5D=fpg_topics_facet%3A8601&page=110.
Locate the element: <p class="usa-footer__contact-info margin-bottom-0">
Confirm the Siteimprove Alfa finding for rule sia-r73 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 1590 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73

Triage status Notes

Moderate alfa sia-r18 Undetermined aria attribute is permitted for element role (WCAG criterion undetermined) 656/8593 pages · 3181 instances Likely template

Bug ID: VS-bcf69cbe
Pattern ID: VS-e05344b9
Combined ID: VS-bcf69cbe (pattern VS-e05344b9) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — aria attribute is permitted for element role [sia-r18]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111
XPath / selector: @aria-selected="true"
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 656 of 8593 scanned pages (3181 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/cot002111.
Locate the element: @aria-selected="true"
Confirm the Siteimprove Alfa finding for rule sia-r18.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 656 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Only use ARIA states/properties that are allowed on this element/role.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r18

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 615/8593 pages · 679 instances Likely template

Bug ID: VS-a50125ce
Pattern ID: VS-d25f622d
Combined ID: VS-a50125ce (pattern VS-d25f622d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Heading levels should only increase by one [heading-order]
Example URL: http://medicaid.gov/medicaid/data-systems/health-information-exchange/federal-financial-participation-for-hit-and-hie
XPath / selector: .field--name-field-resources-list > h3
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<h3>Related Resources</h3>

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 615 of 8593 scanned pages (679 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/data-systems/health-information-exchange/federal-financial-participation-for-hit-and-hie.
Locate the element: .field--name-field-resources-list > h3
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 615 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use heading levels in order (h1 → h2 → h3) without skipping; structure, not size.

Drupal tip: Drupal Views and blocks can insert headings at arbitrary levels. In the Views UI, set "Title tag" for each display. For block titles, configure the heading level in the block's layout settings.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/heading-order?application=axeAPI

Triage status Notes

Minor axe aria-allowed-role Best Practice ARIA role should be appropriate for the element (WCAG criterion undetermined) 470/8593 pages · 1003 instances Likely template

Bug ID: VS-c1d9ae08
Pattern ID: VS-4fac2f41
Combined ID: VS-c1d9ae08 (pattern VS-4fac2f41) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — ARIA role should be appropriate for the element [aria-allowed-role]
Example URL: https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=
XPath / selector: span[data-select2-id="select2-data-1-2krc"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off" autocapitalize="none" spellcheck="false" role="searchbox" aria-autocomplete="list" autocomplete="off" aria-label="S

Description

ARIA role should be appropriate for the element. Detected by axe-core rule aria-allowed-role on 470 of 8593 scanned pages (1003 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=1001&page=5&q=.
Locate the element: span[data-select2-id="select2-data-1-2krc"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
Confirm the axe-core finding for rule aria-allowed-role.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 470 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Remove or change the ARIA role — it isn't allowed on this element type.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/aria-allowed-role?application=axeAPI

Triage status Notes

Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 377/8593 pages · 477 instances Likely template

Bug ID: VS-b1592912
Pattern ID: VS-04a9d28c
Combined ID: VS-b1592912 (pattern VS-04a9d28c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: deprecated-html — Presentational attribute (use CSS) [presentational-attr]
Example URL: https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2611
XPath / selector: td
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<td valign="top" colspan="7" class="dataTables_empty">No data available in table</td>

Description

Presentational attribute (use CSS). Detected by deprecated-html rule presentational-attr on 377 of 8593 scanned pages (477 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2611.
Locate the element: td
Confirm the deprecated-html finding for rule presentational-attr.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 377 pages (CSV).

Testing environment

Automated: deprecated-html, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

Not captured by automated scan — requires manual testing.

Triage status Notes

Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 313/8593 pages · 341 instances Likely template

Bug ID: VS-3383e981
Pattern ID: VS-f054f4a4
Combined ID: VS-3383e981 (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations
XPath / selector: <h4 class="usa-footer__primary-link">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 313 of 8593 scanned pages (341 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/about-section-1115-demonstrations.
Locate the element: <h4 class="usa-footer__primary-link">
Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 313 pages (CSV).

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Use headings in a logical, non-skipping order.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r53

Triage status Notes

Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 135/8593 pages · 136 instances Likely template

Bug ID: VS-e745a5bc
Pattern ID: VS-8806389c
Combined ID: VS-e745a5bc (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person
XPath / selector: .section
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

HTML snippet — use this to validate the finding without re-running the tool

<aside class="section" role="complementary">

Description

Landmarks should have a unique role or role/label/title (i.e. accessible name) c. Detected by axe-core rule landmark-unique on 135 of 8593 scanned pages (136 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/long-term-services-supports/money-follows-person.
Locate the element: .section
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 135 pages (CSV).

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: When a landmark role/type repeats (e.g. two <nav>s), give each a distinct accessible name with aria-label or aria-labelledby (e.g. "Primary" and "Footer" navigation) so screen-reader users can tell them apart.

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-unique?application=axeAPI

Triage status Notes

Moderate alfa sia-r74 WCAG 2.x AAA Link is distinguishable without relying on color (WCAG 1.4.8) 21/8593 pages · 207 instances Likely template

Bug ID: VS-212a1106
Pattern ID: VS-fbf54eba
Combined ID: VS-212a1106 (pattern VS-fbf54eba) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Link is distinguishable without relying on color [sia-r74]
Example URL: https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D
XPath / selector: <p class="welcome-text core-set ng-star-inserted">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 21 of 8593 scanned pages (207 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D.
Locate the element: <p class="welcome-text core-set ng-star-inserted">
Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r74

Triage status Notes

Moderate axe landmark-no-duplicate-main Best Practice Document should not have more than one main landmark (WCAG criterion undetermined) 19/8593 pages · 19 instances Likely template

Bug ID: VS-73d0ed37
Pattern ID: VS-cd69be3a
Combined ID: VS-73d0ed37 (pattern VS-cd69be3a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should not have more than one main landmark [landmark-no-duplicate-main]
Example URL: https://www.medicaid.gov/style-guide/foundation/typography
XPath / selector: .main-content
History: first seen 2026-W28, last seen 2026-W28 (1 wk)

HTML snippet — use this to validate the finding without re-running the tool

<main id="content" class="main-content grid-col-12" role="main">

Description

Document should not have more than one main landmark. Detected by axe-core rule landmark-no-duplicate-main on 19 of 8593 scanned pages (19 instances).

Steps to reproduce

Open https://www.medicaid.gov/style-guide/foundation/typography.
Locate the element: .main-content
Confirm the axe-core finding for rule landmark-no-duplicate-main.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-no-duplicate-main?application=axeAPI

Triage status Notes

Moderate axe landmark-main-is-top-level Best Practice Main landmark should not be contained in another landmark (WCAG criterion undetermined) 19/8593 pages · 19 instances Likely template

Bug ID: VS-c5fe188d
Pattern ID: VS-ff3ceb19
Combined ID: VS-c5fe188d (pattern VS-ff3ceb19) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Main landmark should not be contained in another landmark [landmark-main-is-top-level]
Example URL: https://www.medicaid.gov/style-guide/foundation/typography
XPath / selector: .style-guide-page > .grid-gap-sm.grid-row > main
History: first seen 2026-W28, last seen 2026-W28 (1 wk)

HTML snippet — use this to validate the finding without re-running the tool

<main id="content" class="grid-col-12 desktop:grid-col-9" role="main">

Description

Main landmark should not be contained in another landmark. Detected by axe-core rule landmark-main-is-top-level on 19 of 8593 scanned pages (19 instances).

Steps to reproduce

Open https://www.medicaid.gov/style-guide/foundation/typography.
Locate the element: .style-guide-page > .grid-gap-sm.grid-row > main
Confirm the axe-core finding for rule landmark-main-is-top-level.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/landmark-main-is-top-level?application=axeAPI

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 12/8593 pages · 13 instances Likely template

Bug ID: VS-e86fbc2b
Pattern ID: VS-2cd767ca
Combined ID: VS-e86fbc2b (pattern VS-2cd767ca) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Table header has scope [sia-r78]
Example URL: https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D
XPath / selector: <h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header core-set ng-star-inserted">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 12 of 8593 scanned pages (13 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D.
Locate the element: <h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header core-set ng-star-inserted">
Confirm the Siteimprove Alfa finding for rule sia-r78.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r78

Triage status Notes

Moderate alfa sia-r72 Undetermined Element role is consistent with ARIA landmark (WCAG criterion undetermined) 11/8593 pages · 1842 instances Likely template

Bug ID: VS-a7fbd466
Pattern ID: VS-e5ec42f0
Combined ID: VS-a7fbd466 (pattern VS-e5ec42f0) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Element role is consistent with ARIA landmark [sia-r72]
Example URL: https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D
XPath / selector: <p _ngcontent-ng-c2822395467="" class="title core-set">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 11 of 8593 scanned pages (1842 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D.
Locate the element: <p _ngcontent-ng-c2822395467="" class="title core-set">
Confirm the Siteimprove Alfa finding for rule sia-r72.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r72

Triage status Notes

Moderate alfa sia-r85 Undetermined Keyboard trap does not exist (WCAG criterion undetermined) 11/8593 pages · 636 instances Likely template

Bug ID: VS-d8f5041e
Pattern ID: VS-4c341c77
Combined ID: VS-d8f5041e (pattern VS-4c341c77) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Keyboard trap does not exist [sia-r85]
Example URL: https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D
XPath / selector: <p class="selected-states-header">
History: first seen 2026-W24, last seen 2026-W28 (5 wk)

Description

Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 11 of 8593 scanned pages (636 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22MO%22%5D.
Locate the element: <p class="selected-states-header">
Confirm the Siteimprove Alfa finding for rule sia-r85.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r85

Triage status Notes

Moderate alfa sia-r62 WCAG 2.0 A Link in text block is visually distinguishable without color (WCAG 1.4.1) 2/8593 pages · 7 instances Likely content

Bug ID: VS-6cb7fb9e
Pattern ID: VS-efd91fdd
Combined ID: VS-6cb7fb9e (pattern VS-efd91fdd) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.4.1 Use of Color (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link in text block is visually distinguishable without color [sia-r62]
Example URL: https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality
XPath / selector: <a style="text-decoration:none;" href="#three" title="">
History: first seen 2026-W24, last seen 2026-W28 (3 wk)

Description

Link in text block is visually distinguishable without color. Detected by Siteimprove Alfa rule sia-r62 on 2 of 8593 scanned pages (7 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality.
Locate the element: <a style="text-decoration:none;" href="#three" title="">
Confirm the Siteimprove Alfa finding for rule sia-r62 against WCAG 1.4.1 Use of Color.

Impact

Affects Without color perception (4.5%), Limited vision (2.4%).

Without color perception — 4.5% of population
Limited vision — 2.4% of population

Affected pages

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Make links visually distinguishable from surrounding text (not by color alone).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r62

Triage status Notes

Moderate axe scope-attr-valid Best Practice scope attribute should be used correctly (WCAG criterion undetermined) 1/8593 pages · 51 instances Likely content

Bug ID: VS-1ad781a5
Pattern ID: VS-0ba8ce9d
Combined ID: VS-1ad781a5 (pattern VS-0ba8ce9d) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — scope attribute should be used correctly [scope-attr-valid]
Example URL: https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels
XPath / selector: tr:nth-child(1) > td[scope="row"]
History: first seen 2026-W24, last seen 2026-W28 (4 wk)

HTML snippet — use this to validate the finding without re-running the tool

<td scope="row">Alabama</td>

Description

scope attribute should be used correctly. Detected by axe-core rule scope-attr-valid on 1 of 8593 scanned pages (51 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels.
Locate the element: tr:nth-child(1) > td[scope="row"]
Confirm the axe-core finding for rule scope-attr-valid.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels

Testing environment

Automated: axe-core, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/scope-attr-valid?application=axeAPI

Triage status Notes

Moderate alfa sia-r80 WCAG 2.x AAA Scrollable element is keyboard accessible (WCAG 1.4.8) 1/8593 pages · 2 instances Likely content

Bug ID: VS-5660247f
Pattern ID: VS-388b5438
Combined ID: VS-5660247f (pattern VS-388b5438) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Scrollable element is keyboard accessible [sia-r80]
Example URL: https://www.medicaid.gov/dq-atlas/landing/resources/subscription
XPath / selector: <p _ngcontent-ng-c1416952416="">
History: first seen 2026-W25, last seen 2026-W28 (2 wk)

Description

Scrollable element is keyboard accessible. Detected by Siteimprove Alfa rule sia-r80 on 1 of 8593 scanned pages (2 instances).

Steps to reproduce

Open https://www.medicaid.gov/dq-atlas/landing/resources/subscription.
Locate the element: <p _ngcontent-ng-c1416952416="">
Confirm the Siteimprove Alfa finding for rule sia-r80 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/dq-atlas/landing/resources/subscription

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r80

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 1/8593 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-29ab8ed7
Pattern ID: VS-a24eaa8c
Combined ID: VS-29ab8ed7 (pattern VS-a24eaa8c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 1.1.1 Non-text Content (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Image has accessible name [sia-r2]
Example URL: https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
XPath / selector: <img src="/media/file/monitor-eval-1115-demonstrations0.png/">
History: first seen 2026-W24, last seen 2026-W28 (4 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-38918f70 (pattern VS-9074b4dd). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Image has accessible name. Detected by Siteimprove Alfa rule sia-r2 on 1 of 8593 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation.
Locate the element: <img src="/media/file/monitor-eval-1115-demonstrations0.png/">
Confirm the Siteimprove Alfa finding for rule sia-r2 against WCAG 1.1.1 Non-text Content.

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give every <img> an accessible name (alt text), or alt="" if purely decorative.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r2

Triage status Notes

Moderate alfa sia-r60 Undetermined Input purpose can be determined (WCAG criterion undetermined) 1/8593 pages · 1 instances Likely content

Bug ID: VS-0ad31bbe
Pattern ID: VS-3fb891c5
Combined ID: VS-0ad31bbe (pattern VS-3fb891c5) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Input purpose can be determined [sia-r60]
Example URL: https://www.medicaid.gov/dq-atlas/landing/states
XPath / selector: <div _ngcontent-ng-c305556689="" role="radiogroup" class="toggle-input-container">
History: first seen 2026-W26, last seen 2026-W28 (2 wk)

Description

Input purpose can be determined. Detected by Siteimprove Alfa rule sia-r60 on 1 of 8593 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/dq-atlas/landing/states.
Locate the element: <div _ngcontent-ng-c305556689="" role="radiogroup" class="toggle-input-container">
Confirm the Siteimprove Alfa finding for rule sia-r60.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

/dq-atlas/landing/states

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r60

Triage status Notes

Moderate alfa sia-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 1/8593 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-bf3ec45d
Pattern ID: VS-28ebd979
Combined ID: VS-bf3ec45d (pattern VS-28ebd979) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.4 Link Purpose (In Context) (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Link has accessible name [sia-r11]
Example URL: https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation
XPath / selector: <a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf">
History: first seen 2026-W24, last seen 2026-W28 (4 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-f1a54936 (pattern VS-e9fe47ac). If axe and this engine flag the same element, the axe report takes precedence — mark this as duplicate in JIRA.

Description

Link has accessible name. Detected by Siteimprove Alfa rule sia-r11 on 1 of 8593 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation.
Locate the element: <a href="/medicaid/section-1115-demonstrations/downloads/monitor-eval-1115-demonstrations-infographic.pdf">
Confirm the Siteimprove Alfa finding for rule sia-r11 against WCAG 2.4.4 Link Purpose (In Context).

Impact

Affects Without vision (1.0%), Limited vision (2.4%), Limited cognitive, language, or learning ability (11.0%).

Without vision — 1.0% of population
Limited vision — 2.4% of population
Limited cognitive, language, or learning ability — 11.0% of population

Affected pages

/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation

Testing environment

Automated: Siteimprove Alfa, headless Chromium (Playwright). Manual AT verification: Not captured by automated scan — requires manual testing.

Suggested fix

How to fix: Give the link an accessible name via text content or aria-label.

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r11

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (18 rule type(s))

Each failing rule links out to the axe-core documentation. For full element-level detail including HTML snippets and XPaths, see the bug reports above.

axe-core rules failing in 2026-W28, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
All page content should be contained by landmarks [region]	moderate	5249	23788	/tmsis/dataguide/v3/validation-rules/rule-6117 /tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v3/validation-rules/rule-7953	all 5249 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	5237	5237	/tmsis/dataguide/v3/validation-rules/rule-6117 /tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v3/validation-rules/rule-7953	all 5237 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	5226	5226	/tmsis/dataguide/v3/validation-rules/rule-6117 /tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v3/validation-rules/rule-7953	all 5226 pages (CSV)
Elements must only use supported ARIA attributes [aria-allowed-attr]	critical	1311	6390	/tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v4/data-elements/cot003157 /tmsis/dataguide/v3/data-elements/elg018236	all 1311 pages (CSV)
Certain ARIA roles must contain particular children [aria-required-children]	critical	1311	1311	/tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v4/data-elements/cot003157 /tmsis/dataguide/v3/data-elements/elg018236	all 1311 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	615	679	/medicaid/data-systems/health-information-exchange/federal-financial-participation-for-hit-and-hie /medicaid/home-community-based-services/home-community-based-services-authorities/self-directed-personal-assistant-services-1915-j /medicaid/national-medicaid-chip-program-information/medicaid-chip-enrollment-data/medicaid-and-chip-enrollment-trend-snapshot	all 615 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role]	minor	470	1003	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 470 pages (CSV)
ARIA input fields must have an accessible name [aria-input-field-name]	serious	467	999	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 467 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	135	136	/medicaid/long-term-services-supports/money-follows-person /medicaid/prescription-drugs/pharmacy-pricing /medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation	all 135 pages (CSV)
Main landmark should not be contained in another landmark [landmark-main-is-top-level]	moderate	19	19	/style-guide/foundation/typography /style-guide/foundation /style-guide/foundation/breakpoints	all 19 pages (CSV)
Document should not have more than one main landmark [landmark-no-duplicate-main]	moderate	19	19	/style-guide/foundation/typography /style-guide/foundation /style-guide/foundation/breakpoints	all 19 pages (CSV)
Form elements should have a visible label [label-title-only]	serious	11	46	/medicaid/prescription-drugs/pharmacy-pricing /medicaid/prescription-drugs/state-drug-utilization-data /prior-annual-medicaid-hospice-rate-letters	all 11 pages (CSV)
Select element must have an accessible name [select-name]	critical	2	2	/tmsis/dataguide/t-msis-coding-blog /tmsis/dataguide/v4/technical-instructions	all 2 pages (CSV)
Elements must only use permitted ARIA attributes [aria-prohibited-attr]	serious	2	2	/about-us/where-can-people-get-help-medicaid-chip /state-overviews/state-profiles	all 2 pages (CSV)
scope attribute should be used correctly [scope-attr-valid]	moderate	1	51	/medicaid/national-medicaid-chip-program-information/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels	all 1 pages (CSV)
Elements must meet minimum color contrast ratio thresholds [color-contrast]	serious	1	2	/chip/reports-evaluations	all 1 pages (CSV)
Images must have alternative text [image-alt]	critical	1	1	/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation	all 1 pages (CSV)
Links must have discernible text [link-name]	serious	1	1	/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (21 rule type(s))

Rule-level summary from Siteimprove Alfa (W3C ACT-based). Findings that overlap with axe-core on the same WCAG success criterion are noted as possible duplicates in the bug reports above.

Alfa rules failing in 2026-W28, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Text has enhanced contrast [sia-r66]	n/a	4198	94539	/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v3/validation-rules/rule-2229	all 4198 pages (CSV)
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	4198	58021	/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v3/validation-rules/rule-2229	all 4198 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	4191	104738	/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v3/validation-rules/rule-2229	all 4191 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	2621	2621	/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v3/validation-rules/rule-2229	all 2621 pages (CSV)
Form field label is visible [sia-r61]	n/a	2608	2608	/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v3/validation-rules/rule-2229	all 2608 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	1590	10964	/federal-policy-guidance /medicaid/medicaid-state-plan-amendments /federal-policy-guidance	all 1590 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	1325	1325	/tmsis/dataguide/v4/data-quality-measures/mis-8-026-26 /tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v4/data-elements/cot003157	all 1325 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	858	890	/tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v4/data-elements/cot003157 /tmsis/dataguide/v4/data-elements/ftx003068	all 858 pages (CSV)
aria attribute is permitted for element role [sia-r18]	n/a	656	3181	/tmsis/dataguide/v4/data-elements/cot002111 /tmsis/dataguide/v4/data-elements/cot003157 /tmsis/dataguide/v4/data-elements/ftx003068	all 656 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	313	341	/medicaid/section-1115-demonstrations/about-section-1115-demonstrations /medicaid/data-systems/health-information-technology/health-disparities /about-us/organization/adrienne-delozier	all 313 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	226	483	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 226 pages (CSV)
Form field has accessible name [sia-r8]	n/a	225	482	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 225 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	21	207	/medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/quality-of-care/core-set-data-dashboard/main /resources-for-states/disaster-response-toolkit/federal-disaster-resources	all 21 pages (CSV)
Table header has scope [sia-r78]	n/a	12	13	/medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/quality-of-care/core-set-data-dashboard/main	all 12 pages (CSV)
Element role is consistent with ARIA landmark [sia-r72]	n/a	11	1842	/medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/quality-of-care/core-set-data-dashboard/main	all 11 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	11	636	/medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/quality-of-care/core-set-data-dashboard/main	all 11 pages (CSV)
Link in text block is visually distinguishable without color [sia-r62]	n/a	2	7	/medicaid/quality-of-care/quality-improvement/maternal-infant-health-care-quality /medicaid/quality-of-care/quality-improvement/addressing-childhood-obesity	all 2 pages (CSV)
Scrollable element is keyboard accessible [sia-r80]	n/a	1	2	/dq-atlas/landing/resources/subscription	all 1 pages (CSV)
Image has accessible name [sia-r2]	n/a	1	1	/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation	all 1 pages (CSV)
Link has accessible name [sia-r11]	n/a	1	1	/medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation	all 1 pages (CSV)
Input purpose can be determined [sia-r60]	n/a	1	1	/dq-atlas/landing/states	all 1 pages (CSV)

Unique accessibility issues (axe + Alfa consolidated)

axe and Alfa both implement W3C ACT rules, so the same issue is often caught by both. These are deduplicated by ACT rule and page, so a shared finding counts once (42436 raw engine findings → 41567 unique).

Unique issues (rule × page): 41567
Caught by both engines: 869 highest confidence
axe only: 18497
Alfa only: 22201

4 rule type(s) caught by both engines — highest confidence

Two independent ACT-rule implementations (Deque axe-core and Siteimprove Alfa) flagged the same issue on the same pages. Agreement between separate engines is strong evidence the barrier is real, not a single-tool false positive — the best place to start.

Rules flagged by both axe-core and Alfa in 2026-W28, by pages affected.
Issue	Pages	Rule references
Elements must only use supported ARIA attributes	1327	axe aria-allowed-attr · Alfa sia-r18 · ACT 5c01ea
ARIA input fields must have an accessible name	469	axe aria-input-field-name · Alfa sia-r8 · ACT e086e5
Images must have alternative text	1	axe image-alt · Alfa sia-r2 · ACT 23a2a8
Links must have discernible text	1	axe link-name · Alfa sia-r11 · ACT c487ae