www.medicaid.gov: Accessibility — week 2026-W39

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	3426	1
2.5.5	WCAG 2.5.5	3426	1
1.4.8	WCAG 1.4.8	2889	2
4.1.2	Name, Role, Value (ARIA)	442	4
1.3.1	Info and Relationships (semantic structure)	407	2

Next 10 actions

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

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
Document should have one main landmark · unattributed component Fix one place, resolve ~1041 finding(s) on 1041 page(s). XPath / selector: `html` `<html class="no-js" lang="en">`	Moderate	1041	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 ~1041 finding(s) on 1041 page(s). XPath / selector: `html` `<html class="no-js" lang="en">`	Moderate	1041	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
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~2884 finding(s) on 2884 page(s). XPath / selector: `text: " Feedback "`	Moderate	2884	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
First focusable element is link to main content · unattributed component Fix one place, resolve ~543 finding(s) on 543 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	543	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 ~539 finding(s) on 539 page(s). XPath / selector: `{"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys`	Moderate	539	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r61	pages (CSV)	Decision Assigned to Notes
Certain ARIA roles must contain particular children · unattributed component Fix one place, resolve ~224 finding(s) on 224 page(s). XPath / selector: `.nav` `<div class="nav nav-tabs nav-justified" role="tablist">`	Critical	224	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
All page content should be contained by landmarks · unattributed component Fix one place, resolve ~1046 finding(s) on 1046 page(s). XPath / selector: `.small` `<div class="small p-1">`	Moderate	1046	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 ~1046 finding(s) on 1046 page(s). XPath / selector: `.justify-content-between` `<div class="d-flex justify-content-between m-2 mb-2">`	Moderate	1046	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 ~1046 finding(s) on 1046 page(s). XPath / selector: `.font-weight-bold` `<p class="font-weight-bold m-0 mr-1">Version:</p>`	Moderate	1046	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 ~2883 finding(s) on 2883 page(s). XPath / selector: `<p class="usa-footer__contact-info margin-bottom-0">`	Moderate	2883	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 33 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 2 critical, 3 serious, 27 moderate, 1 minor. By WCAG category: 7 WCAG 2.0 A, 1 WCAG 2.0 AA, 1 WCAG 2.1 A, 1 WCAG 2.2 AA, 4 WCAG 2.x AAA, 10 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 9 prioritized issue type(s); 24 more are available if you switch to "Show everything".

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

Findings needing review

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

Critical axe aria-allowed-attr WCAG 2.0 A Elements must only use supported ARIA attributes (WCAG 4.1.2) 224/6888 pages · 1108 instances Likely template

Bug ID: VS-30b297a6
Pattern ID: VS-1467ea8a
Combined ID: VS-30b297a6 (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://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
XPath / selector: a[href$="#overview"]
History: first seen 2026-W24, last seen 2026-W39 (16 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 224 of 6888 scanned pages (1108 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018.
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 224 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) 224/6888 pages · 224 instances Likely template

Bug ID: VS-f8796fce
Pattern ID: VS-9429bb8d
Combined ID: VS-f8796fce (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://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018
XPath / selector: .nav
History: first seen 2026-W24, last seen 2026-W39 (16 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 224 of 6888 scanned pages (224 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/data-elements/prv002018.
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 224 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) 145/6888 pages · 304 instances Likely template

Bug ID: VS-40071f81
Pattern ID: VS-0841abc2
Combined ID: VS-40071f81 (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=841&page=1&q=
XPath / selector: span[data-select2-id="select2-data-1-vomy"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"]
History: first seen 2026-W24, last seen 2026-W39 (16 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 145 of 6888 scanned pages (304 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=1&q=.
Locate the element: span[data-select2-id="select2-data-1-vomy"] > .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 145 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) 4/6888 pages · 4 instances

Bug ID: VS-8e3fb774
Pattern ID: VS-ebb1c464
Combined ID: VS-8e3fb774 (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://www.medicaid.gov/medicaid/quality-of-care/investing-health-outcomes
XPath / selector: #map-svg-map-default-1790117194
History: first seen 2026-W24, last seen 2026-W39 (14 wk)

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

<div id="map-svg-map-default-1790117194" class="map-container" aria-disabled="true" aria-label="State Map Image. Keyboard navigating users can use dropdown to select state." style="position: relative;

Description

Elements must only use permitted ARIA attributes. Detected by axe-core rule aria-prohibited-attr on 4 of 6888 scanned pages (4 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/investing-health-outcomes.
Locate the element: #map-svg-map-default-1790117194
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 link-name WCAG 2.0 A Links must have discernible text (WCAG 2.4.4) 1/6888 pages · 1 instances Likely content

Bug ID: VS-6ab3b9f4
Pattern ID: VS-e9fe47ac
Combined ID: VS-6ab3b9f4 (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/quality-of-care/performance-measurement/adult-and-child-health-care-quality-measures/childrens-health-care-quality-measures
XPath / selector: li:nth-child(2) > a:nth-child(2)
History: first seen 2026-W24, last seen 2026-W39 (9 wk)

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

<a href="/medicaid/quality-of-care/core-set-data-dashboard/welcome"> </a>

Description

Links must have discernible text. Detected by axe-core rule link-name on 1 of 6888 scanned pages (1 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/quality-of-care/performance-measurement/adult-and-child-health-care-quality-measures/childrens-health-care-quality-measures.
Locate the element: li:nth-child(2) > a:nth-child(2)
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/quality-of-care/performance-measurement/adult-and-child-health-care-quality-measures/childrens-health-care-quality-measures

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

Moderate alfa sia-r14 WCAG 2.1 A Accessible name of link or button matches visible label (WCAG 2.5.3) 284/6888 pages · 284 instances Likely template

Bug ID: VS-dd2d3177
Pattern ID: VS-f7dba940
Combined ID: VS-dd2d3177 (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/v3/data-elements/clt002127
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-W39 (16 wk)

Description

Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 284 of 6888 scanned pages (284 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v3/data-elements/clt002127.
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 284 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) 183/6888 pages · 188 instances · possible duplicate Likely template

Bug ID: VS-013f1e06
Pattern ID: VS-d6097011
Combined ID: VS-013f1e06 (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: http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=1&q=
XPath / selector: <ul class="select2-selection__rendered" id="select2-edit-field-topics-container">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)
Possible duplicate: Same WCAG SC covered by axe report VS-f8796fce (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 183 of 6888 scanned pages (188 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=1&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 183 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) 69/6888 pages · 143 instances Likely template

Bug ID: VS-b343610e
Pattern ID: VS-a48e6078
Combined ID: VS-b343610e (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=841&page=1&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-W39 (16 wk)

Description

Form field has accessible name. Detected by Siteimprove Alfa rule sia-r8 on 69 of 6888 scanned pages (143 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=1&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 69 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) 69/6888 pages · 143 instances Likely template

Bug ID: VS-b42d1c64
Pattern ID: VS-179ad9b3
Combined ID: VS-b42d1c64 (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=841&page=1&q=
XPath / selector: <textarea class="select2-search__field" type="search" tabindex="0" autocorrect="off">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Target size is at least 24×24 CSS pixels or has spacing (Minimum). Detected by Siteimprove Alfa rule sia-r113 on 69 of 6888 scanned pages (143 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=1&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 69 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) 3426/6888 pages · 145314 instances Likely template

Bug ID: VS-a338f232
Pattern ID: VS-646b1e0b
Combined ID: VS-a338f232 (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: http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A871&f%5B1%5D=topics%3A8871&page=0
XPath / selector: text: "Here’s how you know"
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 3426 of 6888 scanned pages (145314 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A871&f%5B1%5D=topics%3A8871&page=0.
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 3426 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) 3426/6888 pages · 86674 instances Likely template

Bug ID: VS-a6b9eb19
Pattern ID: VS-cb53cc4d
Combined ID: VS-a6b9eb19 (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: http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A871&f%5B1%5D=topics%3A8871&page=0
XPath / selector: <button class="usa-button" type="submit">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 3426 of 6888 scanned pages (86674 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A871&f%5B1%5D=topics%3A8871&page=0.
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 3426 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) 3425/6888 pages · 26121 instances Likely template

Bug ID: VS-542a9245
Pattern ID: VS-c18be945
Combined ID: VS-542a9245 (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: http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A871&f%5B1%5D=topics%3A8871&page=0
XPath / selector: text: " Feedback "
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 3425 of 6888 scanned pages (26121 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A871&f%5B1%5D=topics%3A8871&page=0.
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 3425 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) 2885/6888 pages · 3961 instances Likely template

Bug ID: VS-d44f4e7d
Pattern ID: VS-2208081b
Combined ID: VS-d44f4e7d (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/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A871&f%5B1%5D=topics%3A8871&page=0
XPath / selector: <p class="usa-footer__contact-info margin-bottom-0">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 2885 of 6888 scanned pages (3961 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?f%5B0%5D=state%3A871&f%5B1%5D=topics%3A8871&page=0.
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 2885 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) 1046/6888 pages · 4646 instances Likely template

Bug ID: VS-56ed6409
Pattern ID: VS-f18df681
Combined ID: VS-56ed6409 (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://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802
XPath / selector: .small
History: first seen 2026-W24, last seen 2026-W39 (16 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 1046 of 6888 scanned pages (4646 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802.
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 1046 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) 1041/6888 pages · 1041 instances Likely template

Bug ID: VS-06c2f159
Pattern ID: VS-d5d82446
Combined ID: VS-06c2f159 (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://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W39 (16 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 1041 of 6888 scanned pages (1041 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802.
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 1041 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) 1041/6888 pages · 1041 instances Likely template

Bug ID: VS-870d5de7
Pattern ID: VS-fa44f293
Combined ID: VS-870d5de7 (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://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W39 (16 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 1041 of 6888 scanned pages (1041 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/data-quality-measures/rule-7802.
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 1041 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) 543/6888 pages · 543 instances Likely template

Bug ID: VS-eeb1193d
Pattern ID: VS-aa242c2d
Combined ID: VS-eeb1193d (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/mis-79-013-13
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 543 of 6888 scanned pages (543 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13.
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 543 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) 539/6888 pages · 539 instances Likely template

Bug ID: VS-94d21bc6
Pattern ID: VS-7118fead
Combined ID: VS-94d21bc6 (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/mis-79-013-13
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 539 of 6888 scanned pages (539 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13.
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 539 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) 145/6888 pages · 304 instances Likely template

Bug ID: VS-97f0ffca
Pattern ID: VS-4fac2f41
Combined ID: VS-97f0ffca (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=841&page=1&q=
XPath / selector: span[data-select2-id="select2-data-1-vomy"] > .selection > .select2-selection.select2-selection--multiple[role="combobox"] > .select2-search.select2-search--inline > textarea
History: first seen 2026-W24, last seen 2026-W39 (16 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 145 of 6888 scanned pages (304 instances).

Steps to reproduce

Open http://medicaid.gov/medicaid/medicaid-state-plan-amendments?filter%5Bfield_state%5D%5Bin%5D%5B0%5D=841&page=1&q=.
Locate the element: span[data-select2-id="select2-data-1-vomy"] > .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 145 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) 117/6888 pages · 576 instances Likely template

Bug ID: VS-af0f7675
Pattern ID: VS-e05344b9
Combined ID: VS-af0f7675 (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/cot002088
XPath / selector: @aria-selected="true"
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

aria attribute is permitted for element role. Detected by Siteimprove Alfa rule sia-r18 on 117 of 6888 scanned pages (576 instances).

Steps to reproduce

Open https://www.medicaid.gov/tmsis/dataguide/v3/data-elements/cot002088.
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 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: 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) 116/6888 pages · 126 instances Likely template

Bug ID: VS-9261a047
Pattern ID: VS-d25f622d
Combined ID: VS-9261a047 (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://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
XPath / selector: .region-footer-first > .usa-footer__primary-content.usa-footer__primary-content--collapsible > h4
History: first seen 2026-W24, last seen 2026-W39 (16 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 116 of 6888 scanned pages (126 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581.
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 116 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) 65/6888 pages · 77 instances Likely template

Bug ID: VS-c2e4a8e7
Pattern ID: VS-04a9d28c
Combined ID: VS-c2e4a8e7 (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/v4/validation-rules/rule-6734
XPath / selector: td
History: first seen 2026-W24, last seen 2026-W39 (16 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 65 of 6888 scanned pages (77 instances).

Steps to reproduce

Open https://medicaid.gov/tmsis/dataguide/v4/validation-rules/rule-6734.
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 65 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) 58/6888 pages · 63 instances Likely template

Bug ID: VS-559c9eac
Pattern ID: VS-f054f4a4
Combined ID: VS-559c9eac (pattern VS-f054f4a4) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Undetermined
Obligation: unmapped
Handling: review
WCAG SC: undetermined
Rule: Siteimprove Alfa — Headings are structured hierarchically [sia-r53]
Example URL: https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581
XPath / selector: <h4 class="usa-footer__primary-link">
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 58 of 6888 scanned pages (63 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581.
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 58 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) 11/6888 pages · 11 instances Likely template

Bug ID: VS-25bdda85
Pattern ID: VS-8806389c
Combined ID: VS-25bdda85 (pattern VS-8806389c) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Landmarks should have a unique role or role/label/title (i.e. accessible name) c [landmark-unique]
Example URL: https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information
XPath / selector: .section
History: first seen 2026-W24, last seen 2026-W39 (16 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 11 of 6888 scanned pages (11 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/national-medicaid-chip-program-information.
Locate the element: .section
Confirm the axe-core finding for rule landmark-unique.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

How to fix: 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) 4/6888 pages · 91 instances

Bug ID: VS-80fc7ac9
Pattern ID: VS-fbf54eba
Combined ID: VS-80fc7ac9 (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/dq-atlas/landing/resources/release-notes
XPath / selector: <p>
History: first seen 2026-W24, last seen 2026-W39 (16 wk)

Description

Link is distinguishable without relying on color. Detected by Siteimprove Alfa rule sia-r74 on 4 of 6888 scanned pages (91 instances).

Steps to reproduce

Open https://www.medicaid.gov/dq-atlas/landing/resources/release-notes.
Locate the element: <p>
Confirm the Siteimprove Alfa finding for rule sia-r74 against WCAG 1.4.8 Visual Presentation.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe landmark-contentinfo-is-top-level Best Practice Contentinfo landmark should not be contained in another landmark (WCAG criterion undetermined) 3/6888 pages · 3 instances

Bug ID: VS-04559bf6
Pattern ID: VS-424cced9
Combined ID: VS-04559bf6 (pattern VS-424cced9) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Contentinfo landmark should not be contained in another landmark [landmark-contentinfo-is-top-level]
Example URL: https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1961&f%5B1%5D=sub_topic_faq_library_facet%3A1996&f%5B2%5D=sub_topic_faq_library_facet%3A2016&f%5B3%5D=sub_topic_faq_library_facet%3A2346&f%5B4%5D=sub_topic_faq_library_facet%3A2521&f1=Durable+Medical+Equipment&f2=0&f3=0&f4=0&f5=0&f6=0&fd=05%2F22%2F2012&page=7&sb=-published&sl=yes&td=03%2F25%2F2019
XPath / selector: .usa-alert
History: first seen 2026-W25, last seen 2026-W39 (4 wk)

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

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

Description

Contentinfo landmark should not be contained in another landmark. Detected by axe-core rule landmark-contentinfo-is-top-level on 3 of 6888 scanned pages (3 instances).

Steps to reproduce

Open https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1961&f%5B1%5D=sub_topic_faq_library_facet%3A1996&f%5B2%5D=sub_topic_faq_library_facet%3A2016&f%5B3%5D=sub_topic_faq_library_facet%3A2346&f%5B4%5D=sub_topic_faq_library_facet%3A2521&f1=Durable+Medical+Equipment&f2=0&f3=0&f4=0&f5=0&f6=0&fd=05%2F22%2F2012&page=7&sb=-published&sl=yes&td=03%2F25%2F2019.
Locate the element: .usa-alert
Confirm the axe-core finding for rule landmark-contentinfo-is-top-level.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate axe landmark-no-duplicate-contentinfo Best Practice Document should not have more than one contentinfo landmark (WCAG criterion undetermined) 3/6888 pages · 3 instances

Bug ID: VS-9cc6a368
Pattern ID: VS-b465dfd7
Combined ID: VS-9cc6a368 (pattern VS-b465dfd7) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
Rule: axe-core — Document should not have more than one contentinfo landmark [landmark-no-duplicate-contentinfo]
Example URL: https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1961&f%5B1%5D=sub_topic_faq_library_facet%3A1996&f%5B2%5D=sub_topic_faq_library_facet%3A2016&f%5B3%5D=sub_topic_faq_library_facet%3A2346&f%5B4%5D=sub_topic_faq_library_facet%3A2521&f1=Durable+Medical+Equipment&f2=0&f3=0&f4=0&f5=0&f6=0&fd=05%2F22%2F2012&page=7&sb=-published&sl=yes&td=03%2F25%2F2019
XPath / selector: .usa-alert
History: first seen 2026-W25, last seen 2026-W39 (4 wk)

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

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

Description

Document should not have more than one contentinfo landmark. Detected by axe-core rule landmark-no-duplicate-contentinfo on 3 of 6888 scanned pages (3 instances).

Steps to reproduce

Open https://www.medicaid.gov/faq?f%5B0%5D=sub_topic_faq_library_facet%3A1961&f%5B1%5D=sub_topic_faq_library_facet%3A1996&f%5B2%5D=sub_topic_faq_library_facet%3A2016&f%5B3%5D=sub_topic_faq_library_facet%3A2346&f%5B4%5D=sub_topic_faq_library_facet%3A2521&f1=Durable+Medical+Equipment&f2=0&f3=0&f4=0&f5=0&f6=0&fd=05%2F22%2F2012&page=7&sb=-published&sl=yes&td=03%2F25%2F2019.
Locate the element: .usa-alert
Confirm the axe-core finding for rule landmark-no-duplicate-contentinfo.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r78 Undetermined Table header has scope (WCAG criterion undetermined) 2/6888 pages · 2 instances Likely content

Bug ID: VS-7277ff1d
Pattern ID: VS-2cd767ca
Combined ID: VS-7277ff1d (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/dq-atlas/landing/resources/release-notes
XPath / selector: <h2 data-cy="section-header" class="section-header ng-star-inserted">
History: first seen 2026-W24, last seen 2026-W39 (15 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 2 of 6888 scanned pages (2 instances).

Steps to reproduce

Open https://www.medicaid.gov/dq-atlas/landing/resources/release-notes.
Locate the element: <h2 data-cy="section-header" class="section-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-r72 Undetermined Element role is consistent with ARIA landmark (WCAG criterion undetermined) 1/6888 pages · 195 instances Likely content

Bug ID: VS-6fca39a3
Pattern ID: VS-e5ec42f0
Combined ID: VS-6fca39a3 (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%22LA%22%5D
XPath / selector: <p _ngcontent-ng-c2822395467="" class="title core-set">
History: first seen 2026-W24, last seen 2026-W39 (14 wk)

Description

Element role is consistent with ARIA landmark. Detected by Siteimprove Alfa rule sia-r72 on 1 of 6888 scanned pages (195 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22LA%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

/medicaid/quality-of-care/core-set-data-dashboard/main

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r85 Undetermined Keyboard trap does not exist (WCAG criterion undetermined) 1/6888 pages · 67 instances Likely content

Bug ID: VS-69326594
Pattern ID: VS-4c341c77
Combined ID: VS-69326594 (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%22LA%22%5D
XPath / selector: <p class="selected-states-header">
History: first seen 2026-W24, last seen 2026-W39 (12 wk)

Description

Keyboard trap does not exist. Detected by Siteimprove Alfa rule sia-r85 on 1 of 6888 scanned pages (67 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22LA%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

/medicaid/quality-of-care/core-set-data-dashboard/main

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 axe landmark-no-duplicate-main Best Practice Document should not have more than one main landmark (WCAG criterion undetermined) 1/6888 pages · 1 instances Likely content

Bug ID: VS-99949cfd
Pattern ID: VS-cd69be3a
Combined ID: VS-99949cfd (pattern VS-cd69be3a) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
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/spacing
XPath / selector: .main-content
History: first seen 2026-W28, last seen 2026-W39 (9 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 6888 scanned pages (1 instances).

Steps to reproduce

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

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) 1/6888 pages · 1 instances Likely content

Bug ID: VS-fa9f06a1
Pattern ID: VS-ff3ceb19
Combined ID: VS-fa9f06a1 (pattern VS-ff3ceb19) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: Best Practice
Obligation: advisory
Handling: review
WCAG SC: Best Practice — not a WCAG requirement
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/spacing
XPath / selector: .style-guide-page > .grid-gap-sm.grid-row > main
History: first seen 2026-W28, last seen 2026-W39 (9 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 6888 scanned pages (1 instances).

Steps to reproduce

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

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-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 1/6888 pages · 1 instances Likely content

Bug ID: VS-5e22143f
Pattern ID: VS-f7e99f4b
Combined ID: VS-5e22143f (pattern VS-f7e99f4b) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 AA
Obligation: required
Handling: review
WCAG SC: 1.4.3 Contrast (Minimum) (Level AA, WCAG 2.0)
Rule: Siteimprove Alfa — Text has sufficient color contrast (Enhanced) [sia-r69]
Example URL: https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22LA%22%5D
XPath / selector: text: "All"
History: first seen 2026-W39, last seen 2026-W39 (1 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 1 of 6888 scanned pages (1 instances).

Steps to reproduce

Open https://www.medicaid.gov/medicaid/quality-of-care/core-set-data-dashboard/main?focusStates=%5B%22LA%22%5D.
Locate the element: text: "All"
Confirm the Siteimprove Alfa finding for rule sia-r69 against WCAG 1.4.3 Contrast (Minimum).

Impact

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

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

Affected pages

/medicaid/quality-of-care/core-set-data-dashboard/main

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 AA (4.5:1, or 3:1 for large text).

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r69

Triage status Notes

Deque axe-core findings

Rule-level axe-core summary (15 rule type(s))

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

axe-core rules failing in 2026-W39, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
All page content should be contained by landmarks [region]	moderate	1046	4646	/tmsis/dataguide/v4/data-quality-measures/rule-7802 /tmsis/dataguide/v3/data-quality-measures/mis-79-013-13 /tmsis/dataguide/v3/validation-rules/rule-1789	all 1046 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	1041	1041	/tmsis/dataguide/v4/data-quality-measures/rule-7802 /tmsis/dataguide/v3/data-quality-measures/mis-79-013-13 /tmsis/dataguide/v3/validation-rules/rule-1789	all 1041 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	1041	1041	/tmsis/dataguide/v4/data-quality-measures/rule-7802 /tmsis/dataguide/v3/data-quality-measures/mis-79-013-13 /tmsis/dataguide/v3/validation-rules/rule-1789	all 1041 pages (CSV)
Elements must only use supported ARIA attributes [aria-allowed-attr]	critical	224	1108	/tmsis/dataguide/v4/data-elements/prv002018 /tmsis/dataguide/v3/data-elements/cot002088 /tmsis/dataguide/v3/data-elements/clt002127	all 224 pages (CSV)
Certain ARIA roles must contain particular children [aria-required-children]	critical	224	224	/tmsis/dataguide/v4/data-elements/prv002018 /tmsis/dataguide/v3/data-elements/cot002088 /tmsis/dataguide/v3/data-elements/clt002127	all 224 pages (CSV)
ARIA role should be appropriate for the element [aria-allowed-role]	minor	145	304	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 145 pages (CSV)
ARIA input fields must have an accessible name [aria-input-field-name]	serious	145	304	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 145 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	116	126	/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581 /medicaid/section-1115-demonstrations/reentry-section-1115-demonstrations /about-us/organization/adrienne-delozier	all 116 pages (CSV)
Landmarks should have a unique role or role/label/title (i.e. accessible name) combination [landmark-unique]	moderate	11	11	/medicaid/national-medicaid-chip-program-information /medicaid/benefits/prevention /medicaid/quality-of-care/quality-improvement-initiatives/measuring-and-improving-quality-home-and-community-based-services	all 11 pages (CSV)
Elements must only use permitted ARIA attributes [aria-prohibited-attr]	serious	4	4	/medicaid/quality-of-care/investing-health-outcomes /medicaid/quality-of-care/investing-health-outcomes /medicaid/quality-of-care/investing-health-outcomes	all 4 pages (CSV)
Contentinfo landmark should not be contained in another landmark [landmark-contentinfo-is-top-level]	moderate	3	3	/faq /faq /faq	all 3 pages (CSV)
Document should not have more than one contentinfo landmark [landmark-no-duplicate-contentinfo]	moderate	3	3	/faq /faq /faq	all 3 pages (CSV)
Links must have discernible text [link-name]	serious	1	1	/medicaid/quality-of-care/performance-measurement/adult-and-child-health-care-quality-measures/childrens-health-care-quality-measures	all 1 pages (CSV)
Main landmark should not be contained in another landmark [landmark-main-is-top-level]	moderate	1	1	/style-guide/foundation/spacing	all 1 pages (CSV)
Document should not have more than one main landmark [landmark-no-duplicate-main]	moderate	1	1	/style-guide/foundation/spacing	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-W39, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Text has enhanced contrast [sia-r66]	n/a	3426	145314	/medicaid/medicaid-state-plan-amendments /medicaid/section-1115-demo/demonstration-and-waiver-list /federal-policy-guidance	all 3426 pages (CSV)
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	3426	86674	/medicaid/medicaid-state-plan-amendments /medicaid/section-1115-demo/demonstration-and-waiver-list /federal-policy-guidance	all 3426 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	3425	26121	/medicaid/medicaid-state-plan-amendments /medicaid/section-1115-demo/demonstration-and-waiver-list /federal-policy-guidance	all 3425 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	2885	3961	/medicaid/medicaid-state-plan-amendments /medicaid/section-1115-demo/demonstration-and-waiver-list /federal-policy-guidance	all 2885 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	543	543	/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13 /tmsis/dataguide/v4/validation-rules/rule-8898 /tmsis/dataguide/v3/data-quality-measures/el-8-002-2	all 543 pages (CSV)
Form field label is visible [sia-r61]	n/a	539	539	/tmsis/dataguide/v3/data-quality-measures/mis-79-013-13 /tmsis/dataguide/v4/validation-rules/rule-8898 /tmsis/dataguide/v3/data-quality-measures/el-8-002-2	all 539 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	284	284	/tmsis/dataguide/v3/data-elements/clt002127 /tmsis/dataguide/v4/data-elements/clt002023 /tmsis/dataguide/v3/data-elements/prv004066	all 284 pages (CSV)
Presentational children of an element are not focusable [sia-r68]	n/a	183	188	/medicaid/medicaid-state-plan-amendments /tmsis/dataguide/v3/data-elements/cot002088 /tmsis/dataguide/v3/data-elements/clt002127	all 183 pages (CSV)
aria attribute is permitted for element role [sia-r18]	n/a	117	576	/tmsis/dataguide/v3/data-elements/cot002088 /tmsis/dataguide/v3/data-elements/clt002127 /tmsis/dataguide/v4/data-elements/clt002023	all 117 pages (CSV)
Form field has accessible name [sia-r8]	n/a	69	143	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 69 pages (CSV)
Target size is at least 24×24 CSS pixels or has spacing (Minimum) [sia-r113]	n/a	69	143	/medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments /medicaid/medicaid-state-plan-amendments	all 69 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	58	63	/medicaid/prescription-drugs/branded-prescription-drug-fee-program/communication/entry/46581 /about-us/organization/adrienne-delozier /resources-for-states/innovation-accelerator-program/functional-areas/performance-improvement	all 58 pages (CSV)
Link is distinguishable without relying on color [sia-r74]	n/a	4	91	/dq-atlas/landing/resources/release-notes /resources-for-states/disaster-response-toolkit/federal-disaster-resources /medicaid/quality-of-care/core-set-data-dashboard/main	all 4 pages (CSV)
Table header has scope [sia-r78]	n/a	2	2	/dq-atlas/landing/resources/release-notes /medicaid/quality-of-care/core-set-data-dashboard/main	all 2 pages (CSV)
Element role is consistent with ARIA landmark [sia-r72]	n/a	1	195	/medicaid/quality-of-care/core-set-data-dashboard/main	all 1 pages (CSV)
Keyboard trap does not exist [sia-r85]	n/a	1	67	/medicaid/quality-of-care/core-set-data-dashboard/main	all 1 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	1	1	/medicaid/quality-of-care/core-set-data-dashboard/main	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 (19039 raw engine findings → 18854 unique).

Unique issues (rule × page): 18854
Caught by both engines: 185 highest confidence
axe only: 3821
Alfa only: 14848

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-W39, by pages affected.
Issue	Pages	Rule references
Elements must only use supported ARIA attributes	229	axe aria-allowed-attr · Alfa sia-r18 · ACT 5c01ea
ARIA input fields must have an accessible name	145	axe aria-input-field-name · Alfa sia-r8 · ACT e086e5