www.medicaid.gov: Accessibility — week 2026-W33

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	3236	1
2.5.5	WCAG 2.5.5	3236	1
1.4.8	WCAG 1.4.8	2515	2
4.1.2	Name, Role, Value (ARIA)	686	5
1.3.1	Info and Relationships (semantic structure)	584	4

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 ~1487 finding(s) on 1487 page(s). XPath / selector: `html` `<html class="no-js" lang="en">`	Moderate	1487	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 ~1482 finding(s) on 1482 page(s). XPath / selector: `html` `<html class="no-js" lang="en">`	Moderate	1482	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 ~316 finding(s) on 316 page(s). XPath / selector: `.nav` `<div class="nav nav-tabs nav-justified" role="tablist">`	Critical	316	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 ~733 finding(s) on 733 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	733	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 ~729 finding(s) on 729 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	729	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~2508 finding(s) on 2508 page(s). XPath / selector: `text: " Feedback "`	Moderate	2508	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Text has minimum contrast ratio of 4.5:1 · unattributed component Fix one place, resolve ~2503 finding(s) on 2503 page(s). XPath / selector: `<p class="usa-footer__contact-info margin-bottom-0">`	Moderate	2503	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73	pages (CSV)	Decision Assigned to Notes
Accessible name of link or button matches visible label · unattributed component Fix one place, resolve ~375 finding(s) on 375 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	375	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 ~1485 finding(s) on 1485 page(s). XPath / selector: `.small` `<div class="small p-1">`	Moderate	1485	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 ~1484 finding(s) on 1484 page(s). XPath / selector: `.justify-content-between` `<div class="d-flex justify-content-between m-2 mb-2">`	Moderate	1484	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

Bug reports

12 issue type(s) are shown by default out of 37 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 4 critical, 4 serious, 28 moderate, 1 minor. By WCAG category: 13 WCAG 2.0 A, 1 WCAG 2.1 A, 1 WCAG 2.2 AA, 4 WCAG 2.x AAA, 9 Best Practice, 9 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 12 prioritized issue type(s); 25 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) 316/6890 pages · 1535 instances Likely template

Bug ID: VS-9e9fd8cd
Pattern ID: VS-1467ea8a
Combined ID: VS-9e9fd8cd (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/v3/data-elements/cip002209
XPath / selector: a[href$="#overview"]
History: first seen 2026-W24, last seen 2026-W33 (10 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 316 of 6890 scanned pages (1535 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209.
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 316 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) 316/6890 pages · 316 instances Likely template

Bug ID: VS-61d24bb7
Pattern ID: VS-9429bb8d
Combined ID: VS-61d24bb7 (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/v3/data-elements/cip002209
XPath / selector: .nav
History: first seen 2026-W24, last seen 2026-W33 (10 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 316 of 6890 scanned pages (316 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209.
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 316 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) 249/6890 pages · 524 instances Likely template

Bug ID: VS-bd70e1a9
Pattern ID: VS-0841abc2
Combined ID: VS-bd70e1a9 (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: http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=
XPath / selector: span[data-select2-id="select2-data-1-61ts"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
History: first seen 2026-W24, last seen 2026-W33 (10 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 249 of 6890 scanned pages (524 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=.
Locate the element: span[data-select2-id="select2-data-1-61ts"] > .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 249 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

Serious axe aria-prohibited-attr WCAG 2.0 A Elements must only use permitted ARIA attributes (WCAG 4.1.2) 3/6890 pages · 9 instances

Bug ID: VS-4adf7012
Pattern ID: VS-ebb1c464
Combined ID: VS-4adf7012 (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/
XPath / selector: time[datetime="2026-08-04"]
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

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

<time class="nn-card__date flex-shrink-0 text-center margin-right-2 border" datetime="2026-08-04" aria-label="Aug 04">

Description

Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 3 of 6890 scanned pages (9 instances).

Steps to reproduce

Open http://medicaid.gov/.
Locate the element: time[datetime="2026-08-04"]
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) 1/6890 pages · 1 instances Likely content

Bug ID: VS-64562f0f
Pattern ID: VS-9074b4dd
Combined ID: VS-64562f0f (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: http://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-W33 (6 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 6890 scanned pages (1 instances).

Steps to reproduce

Open http://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

Critical axe select-name WCAG 2.0 A Select element must have an accessible name (WCAG 4.1.2) 1/6890 pages · 1 instances Likely content

Bug ID: VS-3684156b
Pattern ID: VS-fab92378
Combined ID: VS-3684156b (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/v3/t-msis-coding-blog
XPath / selector: #items-per-page
History: first seen 2026-W24, last seen 2026-W33 (7 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 1 of 6890 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/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

/tmsis/dataguide/v3/t-msis-coding-blog

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 link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 1/6890 pages · 1 instances Likely content

Bug ID: VS-10f338a8
Pattern ID: VS-e9fe47ac
Combined ID: VS-10f338a8 (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: http://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-W33 (7 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 6890 scanned pages (1 instances).

Steps to reproduce

Open http://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 label-title-only Best Practice Form elements should have a visible label (WCAG criterion undetermined) 2/6890 pages · 8 instances Likely content

Bug ID: VS-4a3849dc
Pattern ID: VS-33841929
Combined ID: VS-4a3849dc (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: https://www.medicaid.gov/style-guide/components/date-picker
XPath / selector: #from-date
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

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

<input placeholder="From" class="usa-input usa-date-picker__external-input" id="from-date" name="from-date" aria-labelledby="appointment-date-label" aria-describedby="appointment-date-hint" type="text

Description

Form elements should have a visible label. Detected by axe-core rule label-title-only on 2 of 6890 scanned pages (8 instances).

Steps to reproduce

Open https://www.medicaid.gov/style-guide/components/date-picker.
Locate the element: #from-date
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) 375/6890 pages · 375 instances Likely template

Bug ID: VS-6341594d
Pattern ID: VS-f7dba940
Combined ID: VS-6341594d (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/exp-11-018-95
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-W33 (10 wk)

Description

Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 375 of 6890 scanned pages (375 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95.
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 375 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) 265/6890 pages · 275 instances · possible duplicate Likely template

Bug ID: VS-b31e2965
Pattern ID: VS-d6097011
Combined ID: VS-b31e2965 (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/v3/data-elements/cip002209
XPath / selector: <div class="nav nav-tabs nav-justified" role="tablist">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-61d24bb7 (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 265 of 6890 scanned pages (275 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209.
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 265 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-r8 WCAG 2.0 A Form field has accessible name (WCAG 4.1.2) 117/6890 pages · 243 instances Likely template

Bug ID: VS-d23cdc6e
Pattern ID: VS-a48e6078
Combined ID: VS-d23cdc6e (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: http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&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-W33 (10 wk)

Description

Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 117 of 6890 scanned pages (243 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&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 117 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-r113 WCAG 2.2 AA Target size is at least 24×24 CSS pixels or has spacing (Minimum) (WCAG 2.5.8) 116/6890 pages · 242 instances Likely template

Bug ID: VS-a5e9f626
Pattern ID: VS-179ad9b3
Combined ID: VS-a5e9f626 (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: http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&q=
XPath / selector: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 116 of 6890 scanned pages (242 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=5&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 116 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-r66 WCAG 2.x AAA Text has enhanced contrast (WCAG 1.4.6) 3236/6890 pages · 127718 instances Likely template

Bug ID: VS-bf4f2ffc
Pattern ID: VS-646b1e0b
Combined ID: VS-bf4f2ffc (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/v3/data-quality-measures/mcr-2-020-22
XPath / selector: text: "Here's how you know "
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3236 of 6890 scanned pages (127718 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
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 3236 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) 3236/6890 pages · 75511 instances Likely template

Bug ID: VS-9f35c1c0
Pattern ID: VS-cb53cc4d
Combined ID: VS-9f35c1c0 (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/v3/data-quality-measures/mcr-2-020-22
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-W33 (10 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3236 of 6890 scanned pages (75511 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
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 3236 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) 3236/6890 pages · 33888 instances Likely template

Bug ID: VS-d50e9eb5
Pattern ID: VS-c18be945
Combined ID: VS-d50e9eb5 (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/v3/data-quality-measures/mcr-2-020-22
XPath / selector: text: " An official website of the United States government "
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3236 of 6890 scanned pages (33888 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
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 3236 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-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 2507/6890 pages · 5281 instances Likely template

Bug ID: VS-92377ca6
Pattern ID: VS-2208081b
Combined ID: VS-92377ca6 (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: http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3
XPath / selector: <p class="usa-footer__contact-info margin-bottom-0">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2507 of 6890 scanned pages (5281 instances).

Steps to reproduce

Open http://medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1971&f%5B1%5D=sub_topic_faq_library_facet%3A2081&f%5B2%5D=sub_topic_faq_library_facet%3A2086&f%5B3%5D=sub_topic_faq_library_facet%3A2376&f%5B4%5D=sub_topic_faq_library_facet%3A2516&page=3.
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 2507 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 axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 1487/6890 pages · 1487 instances Likely template

Bug ID: VS-7c673280
Pattern ID: VS-fa44f293
Combined ID: VS-7c673280 (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/data-quality-measures/mcr-2-020-22
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W33 (10 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 1487 of 6890 scanned pages (1487 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
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 1487 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

Moderate axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 1485/6890 pages · 6616 instances Likely template

Bug ID: VS-53b2eb07
Pattern ID: VS-f18df681
Combined ID: VS-53b2eb07 (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/data-quality-measures/mcr-2-020-22
XPath / selector: .small
History: first seen 2026-W24, last seen 2026-W33 (10 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 1485 of 6890 scanned pages (6616 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
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 1485 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

Moderate axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 1482/6890 pages · 1482 instances Likely template

Bug ID: VS-8afcee82
Pattern ID: VS-d5d82446
Combined ID: VS-8afcee82 (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/data-quality-measures/mcr-2-020-22
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W33 (10 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 1482 of 6890 scanned pages (1482 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
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 1482 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

Moderate alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 733/6890 pages · 733 instances Likely template

Bug ID: VS-23c08e4f
Pattern ID: VS-aa242c2d
Combined ID: VS-23c08e4f (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/v3/data-quality-measures/mcr-2-020-22
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 733 of 6890 scanned pages (733 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
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 733 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) 729/6890 pages · 729 instances Likely template

Bug ID: VS-6091dca1
Pattern ID: VS-7118fead
Combined ID: VS-6091dca1 (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/v3/data-quality-measures/mcr-2-020-22
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 729 of 6890 scanned pages (729 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22.
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 729 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

Minor axe aria-allowed-role Best Practice ARIA role should be appropriate for the element (WCAG criterion undetermined) 250/6890 pages · 526 instances Likely template

Bug ID: VS-afa1c2a8
Pattern ID: VS-4fac2f41
Combined ID: VS-afa1c2a8 (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: http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=
XPath / selector: span[data-select2-id="select2-data-1-61ts"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
History: first seen 2026-W24, last seen 2026-W33 (10 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 250 of 6890 scanned pages (526 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=836&page=16&q=.
Locate the element: span[data-select2-id="select2-data-1-61ts"] > .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 250 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 axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 169/6890 pages · 181 instances Likely template

Bug ID: VS-6b290340
Pattern ID: VS-d25f622d
Combined ID: VS-6b290340 (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/resources-for-states/rural-health
XPath / selector: .region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

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

<h4 class="usa-footer__primary-link">Related Sites</h4>

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 169 of 6890 scanned pages (181 instances).

Steps to reproduce

Open http://medicaid.gov/resources-for-states/rural-health.
Locate the element: .region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 169 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

Moderate alfa sia-r18 Undetermined aria attribute is permitted for element role (WCAG criterion undetermined) 156/6890 pages · 739 instances Likely template

Bug ID: VS-c0ae7748
Pattern ID: VS-e05344b9
Combined ID: VS-c0ae7748 (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/v3/data-elements/cip002209
XPath / selector: @aria-selected="true"
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 156 of 6890 scanned pages (739 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cip002209.
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 156 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 deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 91/6890 pages · 111 instances Likely template

Bug ID: VS-cd3ebc0a
Pattern ID: VS-04a9d28c
Combined ID: VS-cd3ebc0a (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/data-quality-measures/mis-21-021-21
XPath / selector: td
History: first seen 2026-W24, last seen 2026-W33 (10 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 91 of 6890 scanned pages (111 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-21-021-21.
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 91 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) 76/6890 pages · 82 instances Likely template

Bug ID: VS-035707b2
Pattern ID: VS-f054f4a4
Combined ID: VS-035707b2 (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: http://medicaid.gov/resources-for-states/rural-health
XPath / selector: <h4 class="usa-footer__primary-link">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 76 of 6890 scanned pages (82 instances).

Steps to reproduce

Open http://medicaid.gov/resources-for-states/rural-health.
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 76 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) 33/6890 pages · 33 instances Likely template

Bug ID: VS-71095b0a
Pattern ID: VS-8806389c
Combined ID: VS-71095b0a (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/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports
XPath / selector: .section
History: first seen 2026-W24, last seen 2026-W33 (10 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 33 of 6890 scanned pages (33 instances).

Steps to reproduce

Open https://www.medicaid.gov/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports.
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 33 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) 8/6890 pages · 22 instances

Bug ID: VS-3f4d4d7c
Pattern ID: VS-fbf54eba
Combined ID: VS-3f4d4d7c (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%22VI%22%5D
XPath / selector: <p class="welcome-text core-set ng-star-inserted">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 8 of 6890 scanned pages (22 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%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 alfa sia-r85 Undetermined Keyboard trap does not exist (WCAG criterion undetermined) 4/6890 pages · 189 instances

Bug ID: VS-23e06856
Pattern ID: VS-4c341c77
Combined ID: VS-23e06856 (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%22VI%22%5D
XPath / selector: <p class="selected-states-header">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 4 of 6890 scanned pages (189 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%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-r78 Undetermined Table header has scope (WCAG criterion undetermined) 4/6890 pages · 4 instances

Bug ID: VS-5ef16b38
Pattern ID: VS-2cd767ca
Combined ID: VS-5ef16b38 (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%22VI%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-W33 (10 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 4 of 6890 scanned pages (4 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22VI%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) 3/6890 pages · 543 instances

Bug ID: VS-fe52ec28
Pattern ID: VS-e5ec42f0
Combined ID: VS-fe52ec28 (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%22CT%22%5D
XPath / selector: <p _ngcontent-ng-c2822395467="" class="title core-set">
History: first seen 2026-W24, last seen 2026-W33 (10 wk)

Description

Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 3 of 6890 scanned pages (543 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22CT%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 axe landmark-no-duplicate-main Best Practice Document should not have more than one main landmark (WCAG criterion undetermined) 3/6890 pages · 3 instances

Bug ID: VS-966fad96
Pattern ID: VS-cd69be3a
Combined ID: VS-966fad96 (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/components/date-picker
XPath / selector: .main-content
History: first seen 2026-W28, last seen 2026-W33 (6 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 3 of 6890 scanned pages (3 instances).

Steps to reproduce

Open https://www.medicaid.gov/style-guide/components/date-picker.
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) 3/6890 pages · 3 instances

Bug ID: VS-665fa450
Pattern ID: VS-ff3ceb19
Combined ID: VS-665fa450 (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/components/date-picker
XPath / selector: .style-guide-page > .grid-gap-sm.grid-row > main
History: first seen 2026-W28, last seen 2026-W33 (6 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 3 of 6890 scanned pages (3 instances).

Steps to reproduce

Open https://www.medicaid.gov/style-guide/components/date-picker.
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-r46 WCAG 2.0 A Element has required aria-owns (WCAG 1.3.1) 2/6890 pages · 2 instances Likely content

Bug ID: VS-15bc5e81
Pattern ID: VS-4408605e
Combined ID: VS-15bc5e81 (pattern VS-4408605e) — 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 — Element has required aria-owns [sia-r46]
Example URL: https://www.medicaid.gov/state-overviews/puerto-rico.html
XPath / selector: <th>
History: first seen 2026-W24, last seen 2026-W33 (6 wk)

Description

Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 2 of 6890 scanned pages (2 instances).

Steps to reproduce

Open https://www.medicaid.gov/state-overviews/puerto-rico.html.
Locate the element: <th>
Confirm the Siteimprove Alfa finding for rule sia-r46 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

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-r46

Triage status Notes

Moderate alfa sia-r77 WCAG 2.0 A Table cell has header (WCAG 1.3.1) 1/6890 pages · 8 instances Likely content

Bug ID: VS-a31e003b
Pattern ID: VS-3f067795
Combined ID: VS-a31e003b (pattern VS-3f067795) — 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 — Table cell has header [sia-r77]
Example URL: https://www.medicaid.gov/state-overviews/puerto-rico.html
XPath / selector: <td>
History: first seen 2026-W24, last seen 2026-W33 (3 wk)

Description

Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 6890 scanned pages (8 instances).

Steps to reproduce

Open https://www.medicaid.gov/state-overviews/puerto-rico.html.
Locate the element: <td>
Confirm the Siteimprove Alfa finding for rule sia-r77 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

/state-overviews/puerto-rico.html

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-r77

Triage status Notes

Moderate alfa sia-r2 WCAG 2.0 A Image has accessible name (WCAG 1.1.1) 1/6890 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-3ceba623
Pattern ID: VS-a24eaa8c
Combined ID: VS-3ceba623 (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: http://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-W33 (6 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-64562f0f (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 6890 scanned pages (1 instances).

Steps to reproduce

Open http://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-r11 WCAG 2.0 A Link has accessible name (WCAG 2.4.4) 1/6890 pages · 1 instances · possible duplicate Likely content

Bug ID: VS-ea121e34
Pattern ID: VS-28ebd979
Combined ID: VS-ea121e34 (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: http://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-W33 (6 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-10f338a8 (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 6890 scanned pages (1 instances).

Steps to reproduce

Open http://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 (16 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-W33, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Page should contain a level-one heading [page-has-heading-one]	moderate	1487	1487	/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22 /tmsis/dataguide/v4/validation-rules/rule-7317 /tmsis/dataguide/v3/data-elements/cip002209	all 1487 pages (CSV)
All page content should be contained by landmarks [region]	moderate	1485	6616	/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22 /tmsis/dataguide/v4/validation-rules/rule-7317 /tmsis/dataguide/v3/data-elements/cip002209	all 1485 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	1482	1482	/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22 /tmsis/dataguide/v4/validation-rules/rule-7317 /tmsis/dataguide/v3/data-elements/cip002209	all 1482 pages (CSV)
Elements must only use supported ARIA attributes [aria-allowed-attr]	critical	316	1535	/tmsis/dataguide/v3/data-elements/cip002209 /tmsis/dataguide/v4/data-elements/cot002240 /tmsis/dataguide/v4/data-elements/cot003178	all 316 pages (CSV)
Certain ARIA roles must contain particular children [aria-required-children]	critical	316	316	/tmsis/dataguide/v3/data-elements/cip002209 /tmsis/dataguide/v4/data-elements/cot002240 /tmsis/dataguide/v4/data-elements/cot003178	all 316 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role]	minor	250	526	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 250 pages (CSV)
ARIA input fields must have an accessible name [aria-input-field-name]	serious	249	524	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 249 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	169	181	/resources-for-states/rural-health /state-resource-center/disaster-response-toolkit/federal-disaster-resources/entry/54036 /medicaid/prescription-drugs/federal-upper-limit	all 169 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	33	33	/resources-for-states/innovation-accelerator-program/program-areas/promoting-community-integration-through-long-term-services-and-supports /medicaid/managed-care/managed-long-term-services-and-supports /medicaid/section-1115-demonstrations/1115-demonstration-monitoring-evaluation	all 33 pages (CSV)
Elements must only use permitted ARIA attributes [aria-prohibited-attr]	serious	3	9	/ /medicaid/data-systems/it-procurement-opportunities /chip/state-program-information	all 3 pages (CSV)
Main landmark should not be contained in another landmark [landmark-main-is-top-level]	moderate	3	3	/style-guide/components/date-picker /style-guide/components/banner /style-guide/components/accordion	all 3 pages (CSV)
Document should not have more than one main landmark [landmark-no-duplicate-main]	moderate	3	3	/style-guide/components/date-picker /style-guide/components/banner /style-guide/components/accordion	all 3 pages (CSV)
Form elements should have a visible label [label-title-only]	serious	2	8	/style-guide/components/date-picker /medicaid/prescription-drugs/drug-utilization-review/drug-utilization-review-annual-report	all 2 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)
Select element must have an accessible name [select-name]	critical	1	1	/tmsis/dataguide/v3/t-msis-coding-blog	all 1 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (20 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-W33, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Text has enhanced contrast [sia-r66]	n/a	3236	127718	/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22 /faq /tmsis/dataguide/v3/data-elements/cip002209	all 3236 pages (CSV)
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	3236	75511	/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22 /faq /tmsis/dataguide/v3/data-elements/cip002209	all 3236 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	3236	33888	/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22 /faq /tmsis/dataguide/v3/data-elements/cip002209	all 3236 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	2507	5281	/faq /faq /medicaid/medicaid-state-plan-amendments	all 2507 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	733	733	/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22 /tmsis/dataguide/v3/data-elements/cip002209 /tmsis/dataguide/v4/data-quality-measures/exp-11-018-95	all 733 pages (CSV)
Form field label is visible [sia-r61]	n/a	729	729	/tmsis/dataguide/v3/data-quality-measures/mcr-2-020-22 /tmsis/dataguide/v3/data-elements/cip002209 /tmsis/dataguide/v4/data-quality-measures/exp-11-018-95	all 729 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	375	375	/tmsis/dataguide/v4/data-quality-measures/exp-11-018-95 /tmsis/dataguide/v4/data-quality-measures/rule-1126 /tmsis/dataguide/v3/validation-rules/rule-2188	all 375 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	265	275	/tmsis/dataguide/v3/data-elements/cip002209 /medicaid/medicaid-state-plan-amendments /tmsis/dataguide/v4/data-elements/cot002240	all 265 pages (CSV)
aria attribute is permitted for element role [sia-r18]	n/a	156	739	/tmsis/dataguide/v3/data-elements/cip002209 /tmsis/dataguide/v4/data-elements/cot002240 /tmsis/dataguide/v4/data-elements/elg009144	all 156 pages (CSV)
Form field has accessible name [sia-r8]	n/a	117	243	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 117 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	116	242	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 116 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	76	82	/resources-for-states/rural-health /state-overviews/puerto-rico.html /medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/52149	all 76 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	8	22	/medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/quality-of-care/core-set-data-dashboard/main /medicaid/enrollment-strategies/continuous-eligibility-medicaid-and-chip-coverage	all 8 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	4	189	/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 4 pages (CSV)
Table header has scope [sia-r78]	n/a	4	4	/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 4 pages (CSV)
Element role is consistent with ARIA landmark [sia-r72]	n/a	3	543	/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)
Element has required aria-owns [sia-r46]	n/a	2	2	/state-overviews/puerto-rico.html /medicaid/outreach-tools/helping-connect-enrollees-care	all 2 pages (CSV)
Table cell has header [sia-r77]	n/a	1	8	/state-overviews/puerto-rico.html	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)

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 (20607 raw engine findings → 20336 unique).

Unique issues (rule × page): 20336
Caught by both engines: 271 highest confidence
axe only: 5530
Alfa only: 14535

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-W33, by pages affected.
Issue	Pages	Rule references
Elements must only use supported ARIA attributes	323	axe aria-allowed-attr · Alfa sia-r18 · ACT 5c01ea
ARIA input fields must have an accessible name	250	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