vital-scans open quality ledger

www.medicaid.gov: Accessibility — week 2026-W32

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.

SCCriterionPagesRulesNotes
1.4.6 WCAG 1.4.6 3201 1
2.5.5 WCAG 2.5.5 3201 1
1.4.8 WCAG 1.4.8 2453 2
4.1.2 Name, Role, Value (ARIA) 614 4
1.3.1 Info and Relationships (semantic structure) 586 2

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.
ClusterSeverityPagesWho it affectsHow to fixEvidenceDecision
Page should contain a level-one heading · unattributed component
Fix one place, resolve ~1550 finding(s) on 1550 page(s).
XPath / selector: html
<html class="no-js" lang="en">
Moderate 1550 Requires manual testing. See remediation guidance: https://dequeuniversity.com/rules/axe/4.12/page-has-heading-one?application=axeAPI pages (CSV)
Document should have one main landmark · unattributed component
Fix one place, resolve ~1544 finding(s) on 1544 page(s).
XPath / selector: html
<html class="no-js" lang="en">
Moderate 1544 Requires manual testing. Each page should have exactly one <main> landmark. pages (CSV)
Certain ARIA roles must contain particular children · unattributed component
Fix one place, resolve ~328 finding(s) on 328 page(s).
XPath / selector: .nav
<div class="nav nav-tabs nav-justified" role="tablist">
Critical 328 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)
First focusable element is link to main content · unattributed component
Fix one place, resolve ~759 finding(s) on 759 page(s).
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Moderate 759 Requires manual testing. See remediation guidance: https://alfa.siteimprove.com/rules/sia-r87 pages (CSV)
Form field label is visible · unattributed component
Fix one place, resolve ~758 finding(s) on 758 page(s).
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Moderate 758 Requires manual testing. See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61 pages (CSV)
Text has minimum contrast ratio of 4.5:1 · unattributed component
Fix one place, resolve ~2442 finding(s) on 2442 page(s).
XPath / selector: <p class="usa-footer__contact-info margin-bottom-0">
Moderate 2442 Requires manual testing. See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73 pages (CSV)
Accessible name of link or button matches visible label · unattributed component
Fix one place, resolve ~373 finding(s) on 373 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 373 Without vision, Without speech See remediation guidance: https://alfa.siteimprove.com/rules/sia-r14 pages (CSV)
Scrolling content can be accessed by keyboard · unattributed component
Fix one place, resolve ~2444 finding(s) on 2444 page(s).
XPath / selector: text: " Feedback "
Moderate 2444 Requires manual testing. See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57 pages (CSV)
All page content should be contained by landmarks · unattributed component
Fix one place, resolve ~1548 finding(s) on 1548 page(s).
XPath / selector: .small
<div class="small p-1">
Moderate 1548 Requires manual testing. Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region. pages (CSV)
All page content should be contained by landmarks · unattributed component
Fix one place, resolve ~1546 finding(s) on 1546 page(s).
XPath / selector: .justify-content-between
<div class="d-flex justify-content-between m-2 mb-2">
Moderate 1546 Requires manual testing. Wrap all page content in landmarks (header, nav, main, footer) so users can navigate by region. pages (CSV)

Bug reports

9 issue type(s) are shown by default out of 33 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 2 critical, 3 serious, 27 moderate, 1 minor. By WCAG category: 6 WCAG 2.0 A, 1 WCAG 2.1 A, 1 WCAG 2.2 AA, 4 WCAG 2.x AAA, 11 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 9 prioritized issue type(s); 24 more are available if you switch to "Show everything".

1 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.

Link to this finding Critical axe aria-allowed-attr WCAG 2.0 A Elements must only use supported ARIA attributes (WCAG 4.1.2) 328/6885 pages · 1598 instances Likely template
Bug ID
VS-117f4df0
Pattern ID
VS-1467ea8a
Combined ID
VS-117f4df0 (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)
XPath / selector
a[href$="#overview"]
History
first seen 2026-W24, last seen 2026-W32 (9 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 328 of 6885 scanned pages (1598 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274.
  2. Locate the element: a[href$="#overview"]
  3. 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 328 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

Link to this finding Critical axe aria-required-children WCAG 2.0 A Certain ARIA roles must contain particular children (WCAG 1.3.1) 328/6885 pages · 328 instances Likely template
Bug ID
VS-861a9d0a
Pattern ID
VS-9429bb8d
Combined ID
VS-861a9d0a (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)
XPath / selector
.nav
History
first seen 2026-W24, last seen 2026-W32 (9 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 328 of 6885 scanned pages (328 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274.
  2. Locate the element: .nav
  3. 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 328 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

Link to this finding Serious axe aria-input-field-name WCAG 2.0 A ARIA input fields must have an accessible name (WCAG 4.1.2) 187/6885 pages · 395 instances Likely template
Bug ID
VS-ea437282
Pattern ID
VS-0841abc2
Combined ID
VS-ea437282 (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)
XPath / selector
span[data-select2-id="select2-data-1-9djr"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
History
first seen 2026-W24, last seen 2026-W32 (9 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 187 of 6885 scanned pages (395 instances).

Steps to reproduce

  1. Open http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=0&q=.
  2. Locate the element: span[data-select2-id="select2-data-1-9djr"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
  3. 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 187 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

Link to this finding Serious axe aria-prohibited-attr WCAG 2.0 A Elements must only use permitted ARIA attributes (WCAG 4.1.2) 3/6885 pages · 3 instances
Bug ID
VS-a85402ed
Pattern ID
VS-ebb1c464
Combined ID
VS-a85402ed (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)
XPath / selector
#map-svg-map-1749492515862
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

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

<div id="map-svg-map-1749492515862" 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 3 of 6885 scanned pages (3 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals.
  2. Locate the element: #map-svg-map-1749492515862
  3. 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

Link to this finding Serious axe label-title-only Best Practice Form elements should have a visible label (WCAG criterion undetermined) 1/6885 pages · 19 instances Likely content
Bug ID
VS-268cd7c0
Pattern ID
VS-33841929
Combined ID
VS-268cd7c0 (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
XPath / selector
select[aria-labelledby="filter-th-87386-0"]
History
first seen 2026-W24, last seen 2026-W32 (9 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 1 of 6885 scanned pages (19 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing.
  2. Locate the element: select[aria-labelledby="filter-th-87386-0"]
  3. 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

Link to this finding Moderate alfa sia-r14 WCAG 2.1 A Accessible name of link or button matches visible label (WCAG 2.5.3) 373/6885 pages · 373 instances Likely template
Bug ID
VS-f88ad328
Pattern ID
VS-f7dba940
Combined ID
VS-f88ad328 (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)
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-W32 (9 wk)

Description

Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 373 of 6885 scanned pages (373 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-83-029-29.
  2. Locate the element: <a alt="View Changelog, select to access the version history" href="#" class="text-primary btn p-0" data-target="#modalChangelogHistory">
  3. 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 373 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

Link to this finding Moderate alfa sia-r68 WCAG 2.0 A Presentational children of an element are not focusable (WCAG 1.3.1) 258/6885 pages · 269 instances · possible duplicate Likely template
Bug ID
VS-0e28bafa
Pattern ID
VS-d6097011
Combined ID
VS-0e28bafa (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)
XPath / selector
<div class="nav nav-tabs nav-justified" role="tablist">
History
first seen 2026-W24, last seen 2026-W32 (9 wk)
Possible duplicate
Same WCAG SC covered by axe report VS-861a9d0a (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 258 of 6885 scanned pages (269 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274.
  2. Locate the element: <div class="nav nav-tabs nav-justified" role="tablist">
  3. 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 258 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

Link to this finding 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) 97/6885 pages · 205 instances Likely template
Bug ID
VS-536b2faa
Pattern ID
VS-179ad9b3
Combined ID
VS-536b2faa (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)
XPath / selector
<textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 97 of 6885 scanned pages (205 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=7&q=.
  2. Locate the element: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
  3. 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 97 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

Link to this finding Moderate alfa sia-r8 WCAG 2.0 A Form field has accessible name (WCAG 4.1.2) 96/6885 pages · 203 instances Likely template
Bug ID
VS-4bc481e5
Pattern ID
VS-a48e6078
Combined ID
VS-4bc481e5 (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)
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-W32 (9 wk)

Description

Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 96 of 6885 scanned pages (203 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=986&page=7&q=.
  2. Locate the element: <span class="select2-selection select2-selection--multiple" role="combobox" aria-haspopup="true" aria-expanded="false">
  3. 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 96 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

Link to this finding Moderate alfa sia-r66 WCAG 2.x AAA Text has enhanced contrast (WCAG 1.4.6) 3201/6885 pages · 122700 instances Likely template
Bug ID
VS-6bf4d73e
Pattern ID
VS-646b1e0b
Combined ID
VS-6bf4d73e (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)
XPath / selector
text: "Here's how you know "
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3201 of 6885 scanned pages (122700 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
  2. Locate the element: text: "Here's how you know "
  3. 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 3201 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

Link to this finding Moderate alfa sia-r111 WCAG 2.x AAA Target size is at least 44×44 CSS pixels (Enhanced) (WCAG 2.5.5) 3201/6885 pages · 72269 instances Likely template
Bug ID
VS-45e6f629
Pattern ID
VS-cb53cc4d
Combined ID
VS-45e6f629 (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)
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-W32 (9 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3201 of 6885 scanned pages (72269 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
  2. Locate the element: <button class="btn btn-outline-primary dropdown-toggle py-1 px-2" type="button" id="dropdownMenuButton" data-toggle="dropdown">
  3. 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 3201 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

Link to this finding Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 3199/6885 pages · 35513 instances Likely template
Bug ID
VS-32c67cf1
Pattern ID
VS-c18be945
Combined ID
VS-32c67cf1 (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
XPath / selector
text: " An official website of the United States government "
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3199 of 6885 scanned pages (35513 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
  2. Locate the element: text: " An official website of the United States government "
  3. Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 3199 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

Link to this finding Moderate alfa sia-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 2446/6885 pages · 4784 instances Likely template
Bug ID
VS-5681c797
Pattern ID
VS-2208081b
Combined ID
VS-5681c797 (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)
XPath / selector
<p class="usa-footer__contact-info margin-bottom-0">
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2446 of 6885 scanned pages (4784 instances).

Steps to reproduce

  1. Open http://medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list?entry=8530&page=4.
  2. Locate the element: <p class="usa-footer__contact-info margin-bottom-0">
  3. 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 2446 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

Link to this finding Moderate axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 1550/6885 pages · 1550 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
XPath / selector
html
History
first seen 2026-W24, last seen 2026-W32 (9 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 1550 of 6885 scanned pages (1550 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
  2. Locate the element: html
  3. 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 1550 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

Link to this finding Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 1548/6885 pages · 6889 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
XPath / selector
.small
History
first seen 2026-W24, last seen 2026-W32 (9 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 1548 of 6885 scanned pages (6889 instances).

Steps to reproduce

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

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 1548 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

Link to this finding Moderate axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 1544/6885 pages · 1544 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
XPath / selector
html
History
first seen 2026-W24, last seen 2026-W32 (9 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 1544 of 6885 scanned pages (1544 instances).

Steps to reproduce

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

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 1544 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

Link to this finding Moderate alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 759/6885 pages · 759 instances Likely template
Bug ID
VS-55d817d1
Pattern ID
VS-aa242c2d
Combined ID
VS-55d817d1 (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
XPath / selector
{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 759 of 6885 scanned pages (759 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
  2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
  3. Confirm the Siteimprove Alfa finding for rule sia-r87.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 759 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

Link to this finding Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 758/6885 pages · 758 instances Likely template
Bug ID
VS-ec2d63d7
Pattern ID
VS-7118fead
Combined ID
VS-ec2d63d7 (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
XPath / selector
{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 758 of 6885 scanned pages (758 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-6117.
  2. Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
  3. Confirm the Siteimprove Alfa finding for rule sia-r61.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 758 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

Link to this finding Minor axe aria-allowed-role Best Practice ARIA role should be appropriate for the element (WCAG criterion undetermined) 187/6885 pages · 395 instances Likely template
Bug ID
VS-ef2fbe1b
Pattern ID
VS-4fac2f41
Combined ID
VS-ef2fbe1b (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
XPath / selector
span[data-select2-id="select2-data-1-9djr"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
History
first seen 2026-W24, last seen 2026-W32 (9 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 187 of 6885 scanned pages (395 instances).

Steps to reproduce

  1. Open http://medicaid.gov/chip/state-program-information/chip-spa?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=891&page=0&q=.
  2. Locate the element: span[data-select2-id="select2-data-1-9djr"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
  3. Confirm the axe-core finding for rule aria-allowed-role.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 187 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

Link to this finding Moderate alfa sia-r18 Undetermined aria attribute is permitted for element role (WCAG criterion undetermined) 167/6885 pages · 830 instances Likely template
Bug ID
VS-3ee98faa
Pattern ID
VS-e05344b9
Combined ID
VS-3ee98faa (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
XPath / selector
@aria-selected="true"
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 167 of 6885 scanned pages (830 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v4/data-elements/clt004274.
  2. Locate the element: @aria-selected="true"
  3. Confirm the Siteimprove Alfa finding for rule sia-r18.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 167 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

Link to this finding Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 144/6885 pages · 155 instances Likely template
Bug ID
VS-d2c8ff15
Pattern ID
VS-d25f622d
Combined ID
VS-d2c8ff15 (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
XPath / selector
.field--name-field-resources-list > h3
History
first seen 2026-W24, last seen 2026-W32 (9 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 144 of 6885 scanned pages (155 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/medicaid/quality-of-care/quality-improvement-initiatives/well-child-care.
  2. Locate the element: .field--name-field-resources-list > h3
  3. Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 144 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

Link to this finding Moderate deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 98/6885 pages · 126 instances Likely template
Bug ID
VS-654cd4ca
Pattern ID
VS-04a9d28c
Combined ID
VS-654cd4ca (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]
XPath / selector
td
History
first seen 2026-W24, last seen 2026-W32 (9 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 98 of 6885 scanned pages (126 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-1542.
  2. Locate the element: td
  3. Confirm the deprecated-html finding for rule presentational-attr.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 98 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.

Link to this finding Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 78/6885 pages · 82 instances Likely template
Bug ID
VS-28bb9412
Pattern ID
VS-f054f4a4
Combined ID
VS-28bb9412 (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
XPath / selector
<h4 class="usa-footer__primary-link">
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 78 of 6885 scanned pages (82 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166.
  2. Locate the element: <h4 class="usa-footer__primary-link">
  3. Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 78 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

Link to this finding Moderate axe landmark-unique Best Practice Landmarks should have a unique role or role/label/title (i.e. accessible name) c (WCAG criterion undetermined) 27/6885 pages · 27 instances Likely template
Bug ID
VS-b1a8999e
Pattern ID
VS-8806389c
Combined ID
VS-b1a8999e (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
XPath / selector
.landing-page-blue-ribbon > aside
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

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

<aside class="grid-container" 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 27 of 6885 scanned pages (27 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/state-overviews.
  2. Locate the element: .landing-page-blue-ribbon > aside
  3. Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 27 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

Link to this finding Moderate axe landmark-contentinfo-is-top-level Best Practice Contentinfo landmark should not be contained in another landmark (WCAG criterion undetermined) 12/6885 pages · 12 instances Likely template
Bug ID
VS-9da824fc
Pattern ID
VS-424cced9
Combined ID
VS-9da824fc (pattern VS-424cced9) — 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
XPath / selector
.usa-alert
History
first seen 2026-W25, last seen 2026-W32 (3 wk)

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

<div class="usa-alert usa-alert--error usa-alert--slim" role="contentinfo" aria-label="Error message">

Description

Contentinfo landmark should not be contained in another landmark. Detected by axe-core rule landmark-contentinfo-is-top-level on 12 of 6885 scanned pages (12 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2031&f%5B2%5D=sub_topic_faq_library_facet%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2401&page=0.
  2. Locate the element: .usa-alert
  3. Confirm the axe-core finding for rule landmark-contentinfo-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-contentinfo-is-top-level?application=axeAPI

Link to this finding Moderate axe landmark-no-duplicate-contentinfo Best Practice Document should not have more than one contentinfo landmark (WCAG criterion undetermined) 12/6885 pages · 12 instances Likely template
Bug ID
VS-9e937838
Pattern ID
VS-b465dfd7
Combined ID
VS-9e937838 (pattern VS-b465dfd7) — 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
XPath / selector
.usa-alert
History
first seen 2026-W25, last seen 2026-W32 (3 wk)

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

<div class="usa-alert usa-alert--error usa-alert--slim" role="contentinfo" aria-label="Error message">

Description

Document should not have more than one contentinfo landmark. Detected by axe-core rule landmark-no-duplicate-contentinfo on 12 of 6885 scanned pages (12 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1876&f%5B1%5D=sub_topic_faq_library_facet%3A2031&f%5B2%5D=sub_topic_faq_library_facet%3A2091&f%5B3%5D=sub_topic_faq_library_facet%3A2401&page=0.
  2. Locate the element: .usa-alert
  3. Confirm the axe-core finding for rule landmark-no-duplicate-contentinfo.

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

How to fix: Use only one contentinfo landmark (<footer> at the top level) per page.

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

Link to this finding Moderate alfa sia-r74 WCAG 2.x AAA Link is distinguishable without relying on color (WCAG 1.4.8) 7/6885 pages · 68 instances
Bug ID
VS-a946b6b9
Pattern ID
VS-fbf54eba
Combined ID
VS-a946b6b9 (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)
XPath / selector
<p class="field-content">
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 7 of 6885 scanned pages (68 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/resources-for-states/disaster-response-toolkit/federal-disaster-resources?items_per_page=50&page=4.
  2. Locate the element: <p class="field-content">
  3. 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

Link to this finding Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 4/6885 pages · 5 instances
Bug ID
VS-c6b8eb7b
Pattern ID
VS-2cd767ca
Combined ID
VS-c6b8eb7b (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
XPath / selector
<h4>
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 4 of 6885 scanned pages (5 instances).

Steps to reproduce

  1. Open http://medicaid.gov/resources-for-states/medicaid-and-chip-program-portal.
  2. Locate the element: <h4>
  3. 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

Link to this finding Moderate alfa sia-r72 Undetermined Element role is consistent with ARIA landmark (WCAG criterion undetermined) 3/6885 pages · 459 instances
Bug ID
VS-dec7cc39
Pattern ID
VS-e5ec42f0
Combined ID
VS-dec7cc39 (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
XPath / selector
<p _ngcontent-ng-c2822395467="" class="title core-set">
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 3 of 6885 scanned pages (459 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SD%22%5D.
  2. Locate the element: <p _ngcontent-ng-c2822395467="" class="title core-set">
  3. 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

Link to this finding Moderate alfa sia-r85 Undetermined Keyboard trap does not exist (WCAG criterion undetermined) 3/6885 pages · 159 instances
Bug ID
VS-a743e550
Pattern ID
VS-4c341c77
Combined ID
VS-a743e550 (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
XPath / selector
<p class="selected-states-header">
History
first seen 2026-W24, last seen 2026-W32 (9 wk)

Description

Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 3 of 6885 scanned pages (159 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22SD%22%5D.
  2. Locate the element: <p class="selected-states-header">
  3. 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

Link to this finding Moderate axe landmark-no-duplicate-main Best Practice Document should not have more than one main landmark (WCAG criterion undetermined) 2/6885 pages · 2 instances Likely content
Bug ID
VS-99949cfd
Pattern ID
VS-cd69be3a
Combined ID
VS-99949cfd (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
XPath / selector
.main-content
History
first seen 2026-W28, last seen 2026-W32 (5 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 2 of 6885 scanned pages (2 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/style-guide/foundation/spacing.
  2. Locate the element: .main-content
  3. 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

Link to this finding Moderate axe landmark-main-is-top-level Best Practice Main landmark should not be contained in another landmark (WCAG criterion undetermined) 2/6885 pages · 2 instances Likely content
Bug ID
VS-fa9f06a1
Pattern ID
VS-ff3ceb19
Combined ID
VS-fa9f06a1 (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
XPath / selector
.style-guide-page > .grid-gap-sm.grid-row > main
History
first seen 2026-W28, last seen 2026-W32 (5 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 2 of 6885 scanned pages (2 instances).

Steps to reproduce

  1. Open https://www.medicaid.gov/style-guide/foundation/spacing.
  2. Locate the element: .style-guide-page > .grid-gap-sm.grid-row > main
  3. 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

Link to this finding Moderate alfa sia-r60 Undetermined Input purpose can be determined (WCAG criterion undetermined) 1/6885 pages · 1 instances Likely content
Bug ID
VS-e804a412
Pattern ID
VS-3fb891c5
Combined ID
VS-e804a412 (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
XPath / selector
<div _ngcontent-ng-c305556689="" role="radiogroup" class="toggle-input-container">
History
first seen 2026-W26, last seen 2026-W32 (3 wk)

Description

Input purpose can be determined. Detected by Siteimprove Alfa rule sia-r60 on 1 of 6885 scanned pages (1 instances).

Steps to reproduce

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

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-r60

Deque axe-core findings

Rule-level axe-core summary (15 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-W32, by pages affected
RuleImpactPages affectedInstancesExample pagesAll affected
Page should contain a level-one heading [page-has-heading-one] moderate 1550 1550 /tmsis/dataguide/v3/validation-rules/rule-6117
/tmsis/dataguide/v4/validation-rules/rule-8942
/tmsis/dataguide/v3/data-quality-measures/mis-83-029-29
all 1550 pages (CSV)
All page content should be contained by landmarks [region] moderate 1548 6889 /tmsis/dataguide/v3/validation-rules/rule-6117
/tmsis/dataguide/v4/validation-rules/rule-8942
/tmsis/dataguide/v3/data-quality-measures/mis-83-029-29
all 1548 pages (CSV)
Document should have one main landmark [landmark-one-main] moderate 1544 1544 /tmsis/dataguide/v3/validation-rules/rule-6117
/tmsis/dataguide/v4/validation-rules/rule-8942
/tmsis/dataguide/v3/data-quality-measures/mis-83-029-29
all 1544 pages (CSV)
Elements must only use supported ARIA attributes [aria-allowed-attr] critical 328 1598 /tmsis/dataguide/v4/data-elements/clt004274
/tmsis/dataguide/v3/data-elements/cip002106
/tmsis/dataguide/v4/data-elements/cot002240
all 328 pages (CSV)
Certain ARIA roles must contain particular children [aria-required-children] critical 328 328 /tmsis/dataguide/v4/data-elements/clt004274
/tmsis/dataguide/v3/data-elements/cip002106
/tmsis/dataguide/v4/data-elements/cot002240
all 328 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role] minor 187 395 /chip/state-program-information/chip-spa
/medicaid/medicaid-state-plan-amendments
/medicaid/medicaid-state-plan-amendments
all 187 pages (CSV)
ARIA input fields must have an accessible name [aria-input-field-name] serious 187 395 /chip/state-program-information/chip-spa
/medicaid/medicaid-state-plan-amendments
/medicaid/medicaid-state-plan-amendments
all 187 pages (CSV)
Heading levels should only increase by one [heading-order] moderate 144 155 /medicaid/quality-of-care/quality-improvement-initiatives/well-child-care
/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
/state-overviews
all 144 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique] moderate 27 27 /state-overviews
/medicaid/financial-management/payment-limit-demonstrations
/medicaid/financial-management/state-budget-expenditure-reporting-for-medicaid-and-chip/expenditure-reports-mbes/cbes
all 27 pages (CSV)
Contentinfo landmark should not be contained in another landmark [landmark-contentinfo-is-top-level] moderate 12 12 /faq
/faq
/faq
all 12 pages (CSV)
Document should not have more than one contentinfo landmark [landmark-no-duplicate-contentinfo] moderate 12 12 /faq
/faq
/faq
all 12 pages (CSV)
Elements must only use permitted ARIA attributes [aria-prohibited-attr] serious 3 3 /resources-for-states/coronavirus-disease-2019-covid-19/unwinding-and-returning-regular-operations-after-covid-19/covid-19-phe-unwinding-section-1902e14a-waiver-approvals
/about-us/where-can-people-get-help-medicaid-chip
/medicaid/data-systems/it-procurement-opportunities
all 3 pages (CSV)
Main landmark should not be contained in another landmark [landmark-main-is-top-level] moderate 2 2 /style-guide/foundation/spacing
/style-guide/components/banner
all 2 pages (CSV)
Document should not have more than one main landmark [landmark-no-duplicate-main] moderate 2 2 /style-guide/foundation/spacing
/style-guide/components/banner
all 2 pages (CSV)
Form elements should have a visible label [label-title-only] serious 1 19 /medicaid/prescription-drugs/pharmacy-pricing all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (17 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-W32, by pages affected
RuleImpactPages affectedInstancesExample pagesAll affected
Text has enhanced contrast [sia-r66] n/a 3201 122700 /tmsis/dataguide/v3/validation-rules/rule-6117
/medicaid/section-1115-demo/demonstration-and-waiver-list
/faq
all 3201 pages (CSV)
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111] n/a 3201 72269 /tmsis/dataguide/v3/validation-rules/rule-6117
/medicaid/section-1115-demo/demonstration-and-waiver-list
/faq
all 3201 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57] n/a 3199 35513 /tmsis/dataguide/v3/validation-rules/rule-6117
/medicaid/section-1115-demo/demonstration-and-waiver-list
/faq
all 3199 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73] n/a 2446 4784 /medicaid/section-1115-demo/demonstration-and-waiver-list
/faq
/faq
all 2446 pages (CSV)
First focusable element is link to main content [sia-r87] n/a 759 759 /tmsis/dataguide/v3/validation-rules/rule-6117
/tmsis/dataguide/v3/data-quality-measures/mis-83-029-29
/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
all 759 pages (CSV)
Form field label is visible [sia-r61] n/a 758 758 /tmsis/dataguide/v3/validation-rules/rule-6117
/tmsis/dataguide/v3/data-quality-measures/mis-83-029-29
/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
all 758 pages (CSV)
Accessible name of link or button matches visible label [sia-r14] n/a 373 373 /tmsis/dataguide/v3/data-quality-measures/mis-83-029-29
/tmsis/dataguide/v4/data-quality-measures/ffs-9-019-16
/tmsis/dataguide/v3/validation-rules/rule-384
all 373 pages (CSV)
Presentational children of an element are not focusable [sia-r68] n/a 258 269 /tmsis/dataguide/v4/data-elements/clt004274
/tmsis/dataguide/v4/data-elements/cot001014
/tmsis/dataguide/v4/data-elements/cip002163
all 258 pages (CSV)
aria attribute is permitted for element role [sia-r18] n/a 167 830 /tmsis/dataguide/v4/data-elements/clt004274
/tmsis/dataguide/v4/data-elements/cot001014
/tmsis/dataguide/v4/data-elements/cip002163
all 167 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113] n/a 97 205 /medicaid/medicaid-state-plan-amendments
/medicaid/medicaid-state-plan-amendments
/medicaid/section-1115-demo/demonstration-and-waiver-list
all 97 pages (CSV)
Form field has accessible name [sia-r8] n/a 96 203 /medicaid/medicaid-state-plan-amendments
/medicaid/medicaid-state-plan-amendments
/medicaid/section-1115-demo/demonstration-and-waiver-list
all 96 pages (CSV)
Headings are structured hierarchically [sia-r53] n/a 78 82 /state-resource-center/disaster-response-toolkit/federal-disaster-resources/99166
/state-overviews/stateprofile.html
/state-resource-center/disaster-response-toolkit/federal-disaster-resources/97856
all 78 pages (CSV)
Link is distinguishable without relying on color [sia-r74] n/a 7 68 /resources-for-states/disaster-response-toolkit/federal-disaster-resources
/medicaid/prescription-drugs/pharmacy-pricing
/resources-for-states/disaster-response-toolkit/federal-disaster-resources
all 7 pages (CSV)
Table header has scope [sia-r78] n/a 4 5 /resources-for-states/medicaid-and-chip-program-portal
/medicaid/quality-of-care/core-set-data-dashboard/main
/medicaid/quality-of-care/core-set-data-dashboard/main
all 4 pages (CSV)
Element role is consistent with ARIA landmark [sia-r72] n/a 3 459 /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 3 pages (CSV)
Keyboard trap does not exist [sia-r85] n/a 3 159 /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 3 pages (CSV)
Input purpose can be determined [sia-r60] n/a 1 1 /dq-atlas/landing/topics 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 (20526 raw engine findings → 20267 unique).

Unique issues (rule × page)
20267
Caught by both engines
259 highest confidence
axe only
5616
Alfa only
14392
2 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-W32, by pages affected.
IssuePagesRule references
Elements must only use supported ARIA attributes335axe aria-allowed-attr · Alfa sia-r18 · ACT 5c01ea
ARIA input fields must have an accessible name187axe aria-input-field-name · Alfa sia-r8 · ACT e086e5