www.medicaid.gov: Accessibility — week 2026-W37

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	3430	1
2.5.5	WCAG 2.5.5	3430	1
1.4.8	WCAG 1.4.8	2563	2
4.1.2	Name, Role, Value (ARIA)	781	4
1.3.1	Info and Relationships (semantic structure)	768	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
Document should have one main landmark · unattributed component Fix one place, resolve ~1732 finding(s) on 1732 page(s). XPath / selector: `html` `<html class="no-js" lang="en">`	Moderate	1732	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Page should contain a level-one heading · unattributed component Fix one place, resolve ~1731 finding(s) on 1731 page(s). XPath / selector: `html` `<html class="no-js" lang="en">`	Moderate	1731	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
Certain ARIA roles must contain particular children · unattributed component Fix one place, resolve ~425 finding(s) on 425 page(s). XPath / selector: `.nav` `<div class="nav nav-tabs nav-justified" role="tablist">`	Critical	425	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 ~882 finding(s) on 882 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	882	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 ~878 finding(s) on 878 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	878	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 ~2551 finding(s) on 2551 page(s). XPath / selector: `text: " Feedback "`	Moderate	2551	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~1732 finding(s) on 1732 page(s). XPath / selector: `.justify-content-between` `<div class="d-flex justify-content-between m-2 mb-2">`	Moderate	1732	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 ~1732 finding(s) on 1732 page(s). XPath / selector: `.font-weight-bold` `<p class="font-weight-bold m-0 mr-1">Version:</p>`	Moderate	1732	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 ~1731 finding(s) on 1731 page(s). XPath / selector: `.small` `<div class="small p-1">`	Moderate	1731	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
Text has minimum contrast ratio of 4.5:1 · unattributed component Fix one place, resolve ~2548 finding(s) on 2548 page(s). XPath / selector: `<p class="usa-footer__contact-info margin-bottom-0">`	Moderate	2548	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73	pages (CSV)	Decision Assigned to Notes

Bug reports

9 issue type(s) are shown by default out of 31 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 2 critical, 3 serious, 25 moderate, 1 minor. By WCAG category: 8 WCAG 2.0 A, 1 WCAG 2.1 A, 1 WCAG 2.2 AA, 4 WCAG 2.x AAA, 9 Best Practice, 8 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); 22 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.

Critical axe aria-allowed-attr WCAG 2.0 A Elements must only use supported ARIA attributes (WCAG 4.1.2) 425/7188 pages · 2071 instances Likely template

Bug ID: VS-f8c0b898
Pattern ID: VS-1467ea8a
Combined ID: VS-f8c0b898 (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/mcr003042
XPath / selector: a[href$="#overview"]
History: first seen 2026-W24, last seen 2026-W37 (14 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 425 of 7188 scanned pages (2071 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042.
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 425 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) 425/7188 pages · 425 instances Likely template

Bug ID: VS-6730a1cb
Pattern ID: VS-9429bb8d
Combined ID: VS-6730a1cb (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/mcr003042
XPath / selector: .nav
History: first seen 2026-W24, last seen 2026-W37 (14 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 425 of 7188 scanned pages (425 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042.
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 425 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) 229/7188 pages · 476 instances Likely template

Bug ID: VS-ede6cc86
Pattern ID: VS-0841abc2
Combined ID: VS-ede6cc86 (pattern VS-0841abc2) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: axe-core — ARIA input fields must have an accessible name [aria-input-field-name]
Example URL: https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=
XPath / selector: span[data-select2-id="select2-data-1-em6g"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
History: first seen 2026-W24, last seen 2026-W37 (14 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 229 of 7188 scanned pages (476 instances).

Steps to reproduce

Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=.
Locate the element: span[data-select2-id="select2-data-1-em6g"] > .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 229 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) 2/7188 pages · 7 instances Likely content

Bug ID: VS-8ab22672
Pattern ID: VS-ebb1c464
Combined ID: VS-8ab22672 (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: https://medicaid.gov/
XPath / selector: time[datetime="2026-09-11"]
History: first seen 2026-W24, last seen 2026-W37 (13 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="2026-09-11" aria-label="Sep 11">

Description

Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 2 of 7188 scanned pages (7 instances).

Steps to reproduce

Open https://medicaid.gov/.
Locate the element: time[datetime="2026-09-11"]
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

Serious axe label-title-only Best Practice Form elements should have a visible label (WCAG criterion undetermined) 2/7188 pages · 38 instances Likely content

Bug ID: VS-4f56b347
Pattern ID: VS-33841929
Combined ID: VS-4f56b347 (pattern VS-33841929) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Form elements should have a visible label [label-title-only]
Example URL: http://medicaid.gov/medicaid/prescription-drugs/pharmacy-pricing
XPath / selector: select[aria-labelledby="filter-th-87386-0"]
History: first seen 2026-W24, last seen 2026-W37 (13 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 2 of 7188 scanned pages (38 instances).

Steps to reproduce

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

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r14 WCAG 2.1 A Accessible name of link or button matches visible label (WCAG 2.5.3) 471/7188 pages · 471 instances Likely template

Bug ID: VS-86f59ad2
Pattern ID: VS-f7dba940
Combined ID: VS-86f59ad2 (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://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
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-W37 (14 wk)

Description

Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 471 of 7188 scanned pages (471 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614.
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 471 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) 341/7188 pages · 352 instances · possible duplicate Likely template

Bug ID: VS-d9475295
Pattern ID: VS-d6097011
Combined ID: VS-d9475295 (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://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=
XPath / selector: <ul class="select2-selection__rendered" id="select2-edit-field-topics-container">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-6730a1cb (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 341 of 7188 scanned pages (352 instances).

Steps to reproduce

Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=.
Locate the element: <ul class="select2-selection__rendered" id="select2-edit-field-topics-container">
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 341 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) 125/7188 pages · 261 instances Likely template

Bug ID: VS-9df48fd9
Pattern ID: VS-a48e6078
Combined ID: VS-9df48fd9 (pattern VS-a48e6078) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 4.1.2 Name, Role, Value (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Form field has accessible name [sia-r8]
Example URL: https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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-W37 (14 wk)

Description

Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 125 of 7188 scanned pages (261 instances).

Steps to reproduce

Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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 125 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) 125/7188 pages · 261 instances Likely template

Bug ID: VS-7dcc9ed6
Pattern ID: VS-179ad9b3
Combined ID: VS-7dcc9ed6 (pattern VS-179ad9b3) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.2 AA
Obligation: required
Handling: review
WCAG SC: 2.5.8 Target Size (Minimum) (Level AA, WCAG 2.2)
Rule: Siteimprove Alfa — Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]
Example URL: https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=
XPath / selector: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 125 of 7188 scanned pages (261 instances).

Steps to reproduce

Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&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 125 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) 3430/7188 pages · 132252 instances Likely template

Bug ID: VS-82b63c70
Pattern ID: VS-646b1e0b
Combined ID: VS-82b63c70 (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://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
XPath / selector: text: "Here’s how you know"
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3430 of 7188 scanned pages (132252 instances).

Steps to reproduce

Open https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107.
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 3430 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) 3430/7188 pages · 79347 instances Likely template

Bug ID: VS-b83a5dfe
Pattern ID: VS-cb53cc4d
Combined ID: VS-b83a5dfe (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://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
XPath / selector: <button class="usa-button" type="submit">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3430 of 7188 scanned pages (79347 instances).

Steps to reproduce

Open https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107.
Locate the element: <button class="usa-button" type="submit">
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 3430 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) 3428/7188 pages · 40917 instances Likely template

Bug ID: VS-9ef3c4f0
Pattern ID: VS-c18be945
Combined ID: VS-9ef3c4f0 (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://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
XPath / selector: text: " Feedback "
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3428 of 7188 scanned pages (40917 instances).

Steps to reproduce

Open https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107.
Locate the element: text: " Feedback "
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 3428 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) 2552/7188 pages · 3694 instances Likely template

Bug ID: VS-42fe57fb
Pattern ID: VS-2208081b
Combined ID: VS-42fe57fb (pattern VS-2208081b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.x AAA
Obligation: aspirational
Handling: review
WCAG SC: 1.4.8 Visual Presentation (Level AAA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has minimum contrast ratio of 4.5:1 [sia-r73]
Example URL: https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107
XPath / selector: <p class="usa-footer__contact-info margin-bottom-0">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2552 of 7188 scanned pages (3694 instances).

Steps to reproduce

Open https://medicaid.gov/federal-policy-guidance?f%5B0%5D=fpg_topics_facet%3A741&f%5B1%5D=fpg_topics_facet%3A8896&f%5B2%5D=fpg_topics_facet%3A8901&f%5B3%5D=fpg_type_facet%3A1481&page=107.
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 2552 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 region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 1732/7188 pages · 7825 instances Likely template

Bug ID: VS-fd372289
Pattern ID: VS-f18df681
Combined ID: VS-fd372289 (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/mis-22-017-17
XPath / selector: .small
History: first seen 2026-W24, last seen 2026-W37 (14 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 1732 of 7188 scanned pages (7825 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17.
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 1732 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) 1732/7188 pages · 1732 instances Likely template

Bug ID: VS-2b779ee1
Pattern ID: VS-d5d82446
Combined ID: VS-2b779ee1 (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/mis-22-017-17
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W37 (14 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 1732 of 7188 scanned pages (1732 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17.
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 1732 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 axe page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 1731/7188 pages · 1731 instances Likely template

Bug ID: VS-60f983d5
Pattern ID: VS-fa44f293
Combined ID: VS-60f983d5 (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/mis-22-017-17
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W37 (14 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 1731 of 7188 scanned pages (1731 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17.
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 1731 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 alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 882/7188 pages · 882 instances Likely template

Bug ID: VS-f9ec9fe9
Pattern ID: VS-aa242c2d
Combined ID: VS-f9ec9fe9 (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://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 882 of 7188 scanned pages (882 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614.
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 882 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) 878/7188 pages · 878 instances Likely template

Bug ID: VS-7d76ae68
Pattern ID: VS-7118fead
Combined ID: VS-7d76ae68 (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://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 878 of 7188 scanned pages (878 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-2614.
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 878 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) 231/7188 pages · 479 instances Likely template

Bug ID: VS-70cbbd9e
Pattern ID: VS-4fac2f41
Combined ID: VS-70cbbd9e (pattern VS-4fac2f41) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — ARIA role should be appropriate for the element [aria-allowed-role]
Example URL: https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=
XPath / selector: span[data-select2-id="select2-data-1-em6g"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
History: first seen 2026-W24, last seen 2026-W37 (14 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 231 of 7188 scanned pages (479 instances).

Steps to reproduce

Open https://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=716&page=6&q=.
Locate the element: span[data-select2-id="select2-data-1-em6g"] > .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 231 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 alfa sia-r18 Undetermined aria attribute is permitted for element role (WCAG criterion undetermined) 219/7188 pages · 1073 instances Likely template

Bug ID: VS-b0294917
Pattern ID: VS-e05344b9
Combined ID: VS-b0294917 (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/mcr003042
XPath / selector: @aria-selected="true"
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 219 of 7188 scanned pages (1073 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/mcr003042.
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 219 pages (CSV).

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 170/7188 pages · 175 instances Likely template

Bug ID: VS-438614cb
Pattern ID: VS-d25f622d
Combined ID: VS-438614cb (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: https://medicaid.gov/
XPath / selector: #nn-title-192301
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

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

<h4 id="nn-title-192301" class="margin-top-0 margin-bottom-2 nn-card__title">

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 170 of 7188 scanned pages (175 instances).

Steps to reproduce

Open https://medicaid.gov/.
Locate the element: #nn-title-192301
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 170 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 deprecated-html presentational-attr Undetermined Presentational attribute (use CSS) (WCAG criterion undetermined) 114/7188 pages · 134 instances Likely template

Bug ID: VS-c865324e
Pattern ID: VS-04a9d28c
Combined ID: VS-c865324e (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://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2766
XPath / selector: td
History: first seen 2026-W24, last seen 2026-W37 (14 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 114 of 7188 scanned pages (134 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v3/validation-rules/rule-2766.
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 114 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) 85/7188 pages · 88 instances Likely template

Bug ID: VS-c9c0311b
Pattern ID: VS-f054f4a4
Combined ID: VS-c9c0311b (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: https://medicaid.gov/
XPath / selector: <h4 id="nn-title-192301" class="margin-top-0 margin-bottom-2 nn-card__title">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 85 of 7188 scanned pages (88 instances).

Steps to reproduce

Open https://medicaid.gov/.
Locate the element: <h4 id="nn-title-192301" class="margin-top-0 margin-bottom-2 nn-card__title">
Confirm the Siteimprove Alfa finding for rule sia-r53.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 85 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) 32/7188 pages · 32 instances Likely template

Bug ID: VS-f7da2489
Pattern ID: VS-8806389c
Combined ID: VS-f7da2489 (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://medicaid.gov/
XPath / selector: .landing-page-blue-ribbon > aside
History: first seen 2026-W24, last seen 2026-W37 (14 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 32 of 7188 scanned pages (32 instances).

Steps to reproduce

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

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 32 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) 11/7188 pages · 75 instances Likely template

Bug ID: VS-60854c80
Pattern ID: VS-fbf54eba
Combined ID: VS-60854c80 (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/state-overviews/scorecard/main
XPath / selector: <p class="welcome-text ng-star-inserted">
History: first seen 2026-W24, last seen 2026-W37 (14 wk)

Description

Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 11 of 7188 scanned pages (75 instances).

Steps to reproduce

Open https://www.medicaid.gov/state-overviews/scorecard/main.
Locate the element: <p class="welcome-text 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-r72 Undetermined Element role is consistent with ARIA landmark (WCAG criterion undetermined) 4/7188 pages · 382 instances

Bug ID: VS-6536cc0b
Pattern ID: VS-e5ec42f0
Combined ID: VS-6536cc0b (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/state-overviews/scorecard/main
XPath / selector: <p _ngcontent-ng-c2822395467="" class="title scorecard">
History: first seen 2026-W24, last seen 2026-W37 (13 wk)

Description

Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 4 of 7188 scanned pages (382 instances).

Steps to reproduce

Open https://www.medicaid.gov/state-overviews/scorecard/main.
Locate the element: <p _ngcontent-ng-c2822395467="" class="title scorecard">
Confirm the Siteimprove Alfa finding for rule sia-r72.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 4/7188 pages · 4 instances

Bug ID: VS-0d7eae0e
Pattern ID: VS-2cd767ca
Combined ID: VS-0d7eae0e (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/state-overviews/scorecard/main
XPath / selector: <h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header ng-star-inserted">
History: first seen 2026-W24, last seen 2026-W37 (13 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 4 of 7188 scanned pages (4 instances).

Steps to reproduce

Open https://www.medicaid.gov/state-overviews/scorecard/main.
Locate the element: <h3 _ngcontent-ng-c1329502141="" class="view-measures-related-to-header 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-r77 WCAG 2.0 A Table cell has header (WCAG 1.3.1) 1/7188 pages · 2 instances Likely content

Bug ID: VS-fe2e536a
Pattern ID: VS-3f067795
Combined ID: VS-fe2e536a (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/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra
XPath / selector: <td>
History: first seen 2026-W24, last seen 2026-W37 (4 wk)

Description

Table cell has header. Detected by Siteimprove Alfa rule sia-r77 on 1 of 7188 scanned pages (2 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra.
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

/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra

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 axe landmark-no-duplicate-main Best Practice Document should not have more than one main landmark (WCAG criterion undetermined) 1/7188 pages · 1 instances Likely content

Bug ID: VS-e828b1a0
Pattern ID: VS-cd69be3a
Combined ID: VS-e828b1a0 (pattern VS-cd69be3a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should not have more than one main landmark [landmark-no-duplicate-main]
Example URL: https://www.medicaid.gov/style-guide/foundation/breakpoints
XPath / selector: .main-content
History: first seen 2026-W28, last seen 2026-W37 (8 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 1 of 7188 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/style-guide/foundation/breakpoints.
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

/style-guide/foundation/breakpoints

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 alfa sia-r46 WCAG 2.0 A Element has required aria-owns (WCAG 1.3.1) 1/7188 pages · 1 instances Likely content

Bug ID: VS-2bc88e63
Pattern ID: VS-4408605e
Combined ID: VS-2bc88e63 (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/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra
XPath / selector: <th>
History: first seen 2026-W24, last seen 2026-W37 (8 wk)

Description

Element has required aria-owns. Detected by Siteimprove Alfa rule sia-r46 on 1 of 7188 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra.
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

/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra

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 axe landmark-main-is-top-level Best Practice Main landmark should not be contained in another landmark (WCAG criterion undetermined) 1/7188 pages · 1 instances Likely content

Bug ID: VS-dc02d5c2
Pattern ID: VS-ff3ceb19
Combined ID: VS-dc02d5c2 (pattern VS-ff3ceb19) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Main landmark should not be contained in another landmark [landmark-main-is-top-level]
Example URL: https://www.medicaid.gov/style-guide/foundation/breakpoints
XPath / selector: .style-guide-page > .grid-gap-sm.grid-row > main
History: first seen 2026-W28, last seen 2026-W37 (8 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 1 of 7188 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/style-guide/foundation/breakpoints.
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

/style-guide/foundation/breakpoints

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

Deque axe-core findings

Rule-level axe-core summary (13 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-W37, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
All page content should be contained by landmarks [region]	moderate	1732	7825	/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17 /tmsis/dataguide/v4/data-quality-measures/rule-2614 /tmsis/dataguide/v3/validation-rules/rule-1767	all 1732 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	1732	1732	/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17 /tmsis/dataguide/v4/data-quality-measures/rule-2614 /tmsis/dataguide/v3/validation-rules/rule-1767	all 1732 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	1731	1731	/tmsis/dataguide/v3/data-quality-measures/mis-22-017-17 /tmsis/dataguide/v4/data-quality-measures/rule-2614 /tmsis/dataguide/v3/validation-rules/rule-1767	all 1731 pages (CSV)
Elements must only use supported ARIA attributes [aria-allowed-attr]	critical	425	2071	/tmsis/dataguide/v3/data-elements/mcr003042 /tmsis/dataguide/v4/data-elements/ftx005179 /tmsis/dataguide/v3/data-elements/mcr003037	all 425 pages (CSV)
Certain ARIA roles must contain particular children [aria-required-children]	critical	425	425	/tmsis/dataguide/v3/data-elements/mcr003042 /tmsis/dataguide/v4/data-elements/ftx005179 /tmsis/dataguide/v3/data-elements/mcr003037	all 425 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role]	minor	231	479	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 231 pages (CSV)
ARIA input fields must have an accessible name [aria-input-field-name]	serious	229	476	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 229 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	170	175	/ /medicaid/prescription-drugs/pharmacy-pricing /state-resource-center/disaster-response-toolkit/federal-disaster-resources/177991	all 170 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	32	32	/ /medicaid/prescription-drugs/pharmacy-pricing /medicaid/data-systems/medicaid-and-chip-business-information-solution/transformed-medicaid-statistical-information-system-t-msis/t-msis-analytic-files	all 32 pages (CSV)
Form elements should have a visible label [label-title-only]	serious	2	38	/medicaid/prescription-drugs/pharmacy-pricing /medicaid/prescription-drugs/pharmacy-pricing	all 2 pages (CSV)
Elements must only use permitted ARIA attributes [aria-prohibited-attr]	serious	2	7	/ /eligibility	all 2 pages (CSV)
Main landmark should not be contained in another landmark [landmark-main-is-top-level]	moderate	1	1	/style-guide/foundation/breakpoints	all 1 pages (CSV)
Document should not have more than one main landmark [landmark-no-duplicate-main]	moderate	1	1	/style-guide/foundation/breakpoints	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-W37, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Text has enhanced contrast [sia-r66]	n/a	3430	132252	/federal-policy-guidance /medicaid/medicaid-state-plan-amendments /faq	all 3430 pages (CSV)
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	3430	79347	/federal-policy-guidance /medicaid/medicaid-state-plan-amendments /faq	all 3430 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	3428	40917	/federal-policy-guidance /medicaid/medicaid-state-plan-amendments /faq	all 3428 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	2552	3694	/federal-policy-guidance /medicaid/medicaid-state-plan-amendments /faq	all 2552 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	882	882	/tmsis/dataguide/v4/data-quality-measures/rule-2614 /tmsis/dataguide/v3/data-elements/mcr003042 /tmsis/dataguide/v4/data-elements/ftx005179	all 882 pages (CSV)
Form field label is visible [sia-r61]	n/a	878	878	/tmsis/dataguide/v4/data-quality-measures/rule-2614 /tmsis/dataguide/v3/data-elements/mcr003042 /tmsis/dataguide/v4/data-elements/ftx005179	all 878 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	471	471	/tmsis/dataguide/v4/data-quality-measures/rule-2614 /tmsis/dataguide/v3/data-elements/mcr003042 /tmsis/dataguide/v4/data-elements/ftx005179	all 471 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	341	352	/medicaid/medicaid-state-plan-amendments /tmsis/dataguide/v3/data-elements/mcr003042 /tmsis/dataguide/v4/data-elements/ftx005179	all 341 pages (CSV)
aria attribute is permitted for element role [sia-r18]	n/a	219	1073	/tmsis/dataguide/v3/data-elements/mcr003042 /tmsis/dataguide/v4/data-elements/ftx005179 /tmsis/dataguide/v4/data-elements/ftx095377	all 219 pages (CSV)
Form field has accessible name [sia-r8]	n/a	125	261	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 125 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	125	261	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 125 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	85	88	/ /medicaid/program-integrity/affordable-care-act-program-integrity-provisions /medicaid/managed-care/profiles-program-features	all 85 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	11	75	/state-overviews/scorecard/main /resources-for-states/disaster-response-toolkit/federal-disaster-resources /medicaid/quality-of-care/core-set-data-dashboard	all 11 pages (CSV)
Element role is consistent with ARIA landmark [sia-r72]	n/a	4	382	/state-overviews/scorecard/main /state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing /state-overviews/scorecard/main	all 4 pages (CSV)
Table header has scope [sia-r78]	n/a	4	4	/state-overviews/scorecard/main /state-overviews/scorecard/measure/State-Plan-Amendment-and-1915-Waiver-Processing /state-overviews/scorecard/main	all 4 pages (CSV)
Table cell has header [sia-r77]	n/a	1	2	/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra	all 1 pages (CSV)
Element has required aria-owns [sia-r46]	n/a	1	1	/medicaid/prescription-drugs/medicaid-drug-rebate-program/medicaid-national-drug-rebate-agreement-ndra	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 (22700 raw engine findings → 22358 unique).

Unique issues (rule × page): 22358
Caught by both engines: 342 highest confidence
axe only: 6371
Alfa only: 15645

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-W37, by pages affected.
Issue	Pages	Rule references
Elements must only use supported ARIA attributes	429	axe aria-allowed-attr · Alfa sia-r18 · ACT 5c01ea
ARIA input fields must have an accessible name	229	axe aria-input-field-name · Alfa sia-r8 · ACT e086e5