www.medicare.gov: Accessibility — week 2026-W36

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
2.5.5	WCAG 2.5.5	523	1
1.4.8	WCAG 1.4.8	519	1
4.1.2	Name, Role, Value (ARIA)	471	2
1.4.6	WCAG 1.4.6	274	1
2.4.2	Page Titled	23	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.

Design-system alignment (cms-ds / medicare). ds-c-fieldset: 49.3% of sampled rule findings · ds-c-alert: 0.2% of sampled rule findings

Top 10 clustered component fixes for this week.
Cluster	Severity	Pages	Who it affects	How to fix	Evidence	Decision
All page content should be contained by landmarks · ds-c-fieldset Fix one place, resolve ~1669 finding(s) on 1669 page(s). XPath / selector: `#edit-step1` `<fieldset role="group" aria-label="Signup form for email updates" class="ds-c-fieldset ds-u-margin-top--0 js-form-item form-item js-form-wrapper form-wrapper" data-drupal-selector="edit-step1" id="edi`	Serious	1669	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 ~1660 finding(s) on 1660 page(s). XPath / selector: `.ds-u-clearfix` `<div class="ds-u-clearfix form-block__intro">`	Serious	1660	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
aria-hidden element does not contain focusable elements · unattributed component Fix one place, resolve ~456 finding(s) on 456 page(s). XPath / selector: `<div class="search-block__content" aria-hidden="true" id="search_form_block-content">`	Moderate	456	Without vision, Limited vision, Limited manipulation/strength	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r17	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~457 finding(s) on 457 page(s). XPath / selector: `text: " Important updates, straight to your inbox "`	Moderate	457	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~457 finding(s) on 457 page(s). XPath / selector: `text: "Get reminders about Open Enrollment, ways to save costs, and more."`	Moderate	457	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Scrolling content can be accessed by keyboard · unattributed component Fix one place, resolve ~457 finding(s) on 457 page(s). XPath / selector: `text: "Enter your email address"`	Moderate	457	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r57	pages (CSV)	Decision Assigned to Notes
Documents must have <title> element to aid in navigation · unattributed component Fix one place, resolve ~18 finding(s) on 18 page(s). XPath / selector: `html` `<html lang="en">`	Serious	18	Without vision, Limited vision, Limited cognitive, language, or learning ability	Give the page a unique, descriptive <title>.	pages (CSV)	Decision Assigned to Notes
Frames must have an accessible name · unattributed component Fix one place, resolve ~15 finding(s) on 15 page(s). XPath / selector: `iframe[height="100%"]` `<iframe data-src="https://surveys.cms...." width="100%" height="100%" frameborder="0" name="survey-iframe-SI_6tb..." data-name="embedded-iframe-SI_6..." allow="local-network-access" style="border-radi`	Serious	15	Without vision, Limited vision, Limited manipulation/strength	Give every <iframe> a descriptive title attribute.	pages (CSV)	Decision Assigned to Notes
Document should have one main landmark · unattributed component Fix one place, resolve ~21 finding(s) on 21 page(s). XPath / selector: `html` `<html lang="en">`	Moderate	21	Requires manual testing.	Each page should have exactly one <main> landmark.	pages (CSV)	Decision Assigned to Notes
Text has minimum contrast ratio of 4.5:1 · unattributed component Fix one place, resolve ~1261 finding(s) on 450 page(s). XPath / selector: `<p>`	Moderate	450	Requires manual testing.	See remediation guidance: https://alfa.siteimprove.com/rules/sia-r73	pages (CSV)	Decision Assigned to Notes

Bug reports

4 issue type(s) are shown by default out of 19 total. Prioritized by severity, key pages, WCAG level, and prevalence; use the toggle to show everything.

Overall severity mix: 3 serious, 15 moderate, 1 minor. By WCAG category: 4 WCAG 2.0 A, 1 WCAG 2.0 AA, 1 WCAG 2.1 A, 3 WCAG 2.x AAA, 5 Best Practice, 5 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 4 prioritized issue type(s); 15 more are available if you switch to "Show everything".

Findings needing review

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

Serious axe document-title WCAG 2.0 A Documents must have <title> element to aid in navigation (WCAG 2.4.2) 18/1990 pages · 18 instances Likely template

Bug ID: VS-6b7a29c6
Pattern ID: VS-c80d5faa
Combined ID: VS-6b7a29c6 (pattern VS-c80d5faa) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.2 Page Titled (Level A, WCAG 2.0)
Rule: axe-core — Documents must have <title> element to aid in navigation [document-title]
Example URL: https://www.medicare.gov/care-compare/resources/nursing-home/care-compare/resources/nursing-home/quality-of-resident-care
XPath / selector: html
History: first seen 2026-W32, last seen 2026-W36 (5 wk)

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

<html lang="en">

Description

Documents must have <title> element to aid in navigation. Detected by axe-core rule document-title on 18 of 1990 scanned pages (18 instances).

Steps to reproduce

Open https://www.medicare.gov/care-compare/resources/nursing-home/care-compare/resources/nursing-home/quality-of-resident-care.
Locate the element: html
Confirm the axe-core finding for rule document-title against WCAG 2.4.2 Page Titled.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

How to fix: Give the page a unique, descriptive <title>.

Drupal tip: Drupal generates page titles from the node title + site name. Customise the pattern at Admin › Configuration › Search and metadata › Metatag.

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

Triage status Notes

Serious axe frame-title WCAG 2.0 A Frames must have an accessible name (WCAG 4.1.2) 15/1990 pages · 15 instances Likely template

Bug ID: VS-92203821
Pattern ID: VS-3f76c7ea
Combined ID: VS-92203821 (pattern VS-3f76c7ea) — 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 — Frames must have an accessible name [frame-title]
Example URL: http://medicare.gov/publication-ordering/11377
XPath / selector: iframe[height="100%"]
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

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

<iframe data-src="https://surveys.cms...." width="100%" height="100%" frameborder="0" name="survey-iframe-SI_6tb..." data-name="embedded-iframe-SI_6..." allow="local-network-access" style="border-radi

Description

Frames must have an accessible name. Detected by axe-core rule frame-title on 15 of 1990 scanned pages (15 instances).

Steps to reproduce

Open http://medicare.gov/publication-ordering/11377.
Locate the element: iframe[height="100%"]
Confirm the axe-core finding for rule frame-title against WCAG 4.1.2 Name, Role, Value.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

How to fix: Give every <iframe> a descriptive title attribute.

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

Triage status Notes

Serious axe region Best Practice All page content should be contained by landmarks (WCAG criterion undetermined) 1690/1990 pages · 3383 instances Likely template

Bug ID: VS-e5af4051
Pattern ID: VS-f18df681
Combined ID: VS-e5af4051 (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: http://medicare.gov/publication-ordering/11377
XPath / selector: .ds-u-clearfix
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

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

<div class="ds-u-clearfix form-block__intro">

Description

All page content should be contained by landmarks. Detected by axe-core rule region on 1690 of 1990 scanned pages (3383 instances).

Steps to reproduce

Open http://medicare.gov/publication-ordering/11377.
Locate the element: .ds-u-clearfix
Confirm the axe-core finding for rule region.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 1690 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 alfa sia-r17 WCAG 2.0 A aria-hidden element does not contain focusable elements (WCAG 4.1.2) 456/1990 pages · 465 instances Likely template

Bug ID: VS-5d0cfc79
Pattern ID: VS-f6cf30ff
Combined ID: VS-5d0cfc79 (pattern VS-f6cf30ff) — 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 — aria-hidden element does not contain focusable elements [sia-r17]
Example URL: http://medicare.gov/publication-ordering/11377
XPath / selector: <div class="search-block__content" aria-hidden="true" id="search_form_block-content">
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

aria-hidden element does not contain focusable elements. Detected by Siteimprove Alfa rule sia-r17 on 456 of 1990 scanned pages (465 instances).

Steps to reproduce

Open http://medicare.gov/publication-ordering/11377.
Locate the element: <div class="search-block__content" aria-hidden="true" id="search_form_block-content">
Confirm the Siteimprove Alfa finding for rule sia-r17 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 456 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-r17

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) 523/1990 pages · 17501 instances Likely template

Bug ID: VS-e13a4735
Pattern ID: VS-cb53cc4d
Combined ID: VS-e13a4735 (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://medicare.gov/publication-ordering/11377
XPath / selector: <a href="/health-drug-plans" rel="noopener" data-drupal-link-system-path="node/110756" data-listener-attached="true">
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Target size is at least 44×44 CSS pixels (Enhanced). Detected by Siteimprove Alfa rule sia-r111 on 523 of 1990 scanned pages (17501 instances).

Steps to reproduce

Open http://medicare.gov/publication-ordering/11377.
Locate the element: <a href="/health-drug-plans" rel="noopener" data-drupal-link-system-path="node/110756" data-listener-attached="true">
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 523 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-r73 WCAG 2.x AAA Text has minimum contrast ratio of 4.5:1 (WCAG 1.4.8) 519/1990 pages · 5158 instances Likely template

Bug ID: VS-dbffec05
Pattern ID: VS-2208081b
Combined ID: VS-dbffec05 (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://medicare.gov/publication-ordering/11377
XPath / selector: <p>
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Text has minimum contrast ratio of 4.5:1. Detected by Siteimprove Alfa rule sia-r73 on 519 of 1990 scanned pages (5158 instances).

Steps to reproduce

Open http://medicare.gov/publication-ordering/11377.
Locate the element: <p>
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 519 pages (CSV).

Testing environment

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

Suggested fix

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

Triage status Notes

Moderate alfa sia-r57 Undetermined Scrolling content can be accessed by keyboard (WCAG criterion undetermined) 487/1990 pages · 3116 instances Likely template

Bug ID: VS-a689efc2
Pattern ID: VS-c18be945
Combined ID: VS-a689efc2 (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://medicare.gov/publication-ordering/11377
XPath / selector: text: " Important updates, straight to your inbox "
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Scrolling content can be accessed by keyboard. Detected by Siteimprove Alfa rule sia-r57 on 487 of 1990 scanned pages (3116 instances).

Steps to reproduce

Open http://medicare.gov/publication-ordering/11377.
Locate the element: text: " Important updates, straight to your inbox "
Confirm the Siteimprove Alfa finding for rule sia-r57.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 487 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-r66 WCAG 2.x AAA Text has enhanced contrast (WCAG 1.4.6) 274/1990 pages · 587 instances Likely template

Bug ID: VS-ce311d36
Pattern ID: VS-646b1e0b
Combined ID: VS-ce311d36 (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://medicare.gov/coverage/alcohol-misuse-screenings-counseling
XPath / selector: text: "Feedback"
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Text has enhanced contrast. Detected by Siteimprove Alfa rule sia-r66 on 274 of 1990 scanned pages (587 instances).

Steps to reproduce

Open http://medicare.gov/coverage/alcohol-misuse-screenings-counseling.
Locate the element: text: "Feedback"
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 274 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-r78 Undetermined Table header has scope (WCAG criterion undetermined) 143/1990 pages · 183 instances Likely template

Bug ID: VS-6f88336e
Pattern ID: VS-2cd767ca
Combined ID: VS-6f88336e (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.medicare.gov/prescription-payment-plan
XPath / selector: <h2>
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Table header has scope. Detected by Siteimprove Alfa rule sia-r78 on 143 of 1990 scanned pages (183 instances).

Steps to reproduce

Open https://www.medicare.gov/prescription-payment-plan.
Locate the element: <h2>
Confirm the Siteimprove Alfa finding for rule sia-r78.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 143 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-r78

Triage status Notes

Moderate axe heading-order Best Practice Heading levels should only increase by one (WCAG criterion undetermined) 40/1990 pages · 40 instances Likely template

Bug ID: VS-99e6ff9b
Pattern ID: VS-d25f622d
Combined ID: VS-99e6ff9b (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://medicare.gov/publications/search/all-non-english-pubs?page=4
XPath / selector: .layout__column.ds-l-col--12 > h3:nth-child(1)
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

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

<h3>Polish</h3>

Description

Heading levels should only increase by one. Detected by axe-core rule heading-order on 40 of 1990 scanned pages (40 instances).

Steps to reproduce

Open https://medicare.gov/publications/search/all-non-english-pubs?page=4.
Locate the element: .layout__column.ds-l-col--12 > h3:nth-child(1)
Confirm the axe-core finding for rule heading-order.

Impact

Not captured by automated scan — requires manual testing.

Affected pages

…and more — all 40 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 axe landmark-one-main Best Practice Document should have one main landmark (WCAG criterion undetermined) 21/1990 pages · 21 instances Likely template

Bug ID: VS-ecfe3a79
Pattern ID: VS-d5d82446
Combined ID: VS-ecfe3a79 (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.medicare.gov/care-compare/resources/nursing-home/care-compare/resources/nursing-home/quality-of-resident-care
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

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

<html lang="en">

Description

Document should have one main landmark. Detected by axe-core rule landmark-one-main on 21 of 1990 scanned pages (21 instances).

Steps to reproduce

Open https://www.medicare.gov/care-compare/resources/nursing-home/care-compare/resources/nursing-home/quality-of-resident-care.
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

Testing environment

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

Suggested fix

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

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

Triage status Notes

Moderate alfa sia-r87 Undetermined First focusable element is link to main content (WCAG criterion undetermined) 15/1990 pages · 15 instances Likely template

Bug ID: VS-f1675e48
Pattern ID: VS-aa242c2d
Combined ID: VS-f1675e48 (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.medicare.gov/care-compare?guidedSearch=DialysisFacility
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

First focusable element is link to main content. Detected by Siteimprove Alfa rule sia-r87 on 15 of 1990 scanned pages (15 instances).

Steps to reproduce

Open https://www.medicare.gov/care-compare?guidedSearch=DialysisFacility.
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

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-r69 WCAG 2.0 AA Text has sufficient color contrast (Enhanced) (WCAG 1.4.3) 9/1990 pages · 47 instances

Bug ID: VS-8024475d
Pattern ID: VS-f7e99f4b
Combined ID: VS-8024475d (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: http://medicare.gov/coverage/mental-health-substance-use-disorder
XPath / selector: text: "For finding the care you need"
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Text has sufficient color contrast (Enhanced). Detected by Siteimprove Alfa rule sia-r69 on 9 of 1990 scanned pages (47 instances).

Steps to reproduce

Open http://medicare.gov/coverage/mental-health-substance-use-disorder.
Locate the element: text: "For finding the care you need"
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

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

Moderate alfa sia-r53 Undetermined Headings are structured hierarchically (WCAG criterion undetermined) 9/1990 pages · 9 instances

Bug ID: VS-2ec54c2d
Pattern ID: VS-f054f4a4
Combined ID: VS-2ec54c2d (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://medicare.gov/publications/search/all-non-english-pubs
XPath / selector: <h3>
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Headings are structured hierarchically. Detected by Siteimprove Alfa rule sia-r53 on 9 of 1990 scanned pages (9 instances).

Steps to reproduce

Open https://medicare.gov/publications/search/all-non-english-pubs.
Locate the element: <h3>
Confirm the Siteimprove Alfa finding for rule sia-r53.

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

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 page-has-heading-one Best Practice Page should contain a level-one heading (WCAG criterion undetermined) 9/1990 pages · 9 instances

Bug ID: VS-76f781fc
Pattern ID: VS-fa44f293
Combined ID: VS-76f781fc (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: http://medicare.gov/publications/search/item/112371
XPath / selector: html
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

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

<html lang="en" dir="ltr" prefix="og: https://ogp.me/ns#" class=" js">

Description

Page should contain a level-one heading. Detected by axe-core rule page-has-heading-one on 9 of 1990 scanned pages (9 instances).

Steps to reproduce

Open http://medicare.gov/publications/search/item/112371.
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

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-r14 WCAG 2.1 A Accessible name of link or button matches visible label (WCAG 2.5.3) 5/1990 pages · 7 instances

Bug ID: VS-0f4c6e89
Pattern ID: VS-f7dba940
Combined ID: VS-0f4c6e89 (pattern VS-f7dba940) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.1 A
Obligation: required
Handling: review
WCAG SC: 2.5.3 Label in Name (Level A, WCAG 2.1)
Rule: Siteimprove Alfa — Accessible name of link or button matches visible label [sia-r14]
Example URL: https://www.medicare.gov/prescription-payment-plan
XPath / selector: <button class="video-embed-field-lazy-play" aria-label="Play video">
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Accessible name of link or button matches visible label. Detected by Siteimprove Alfa rule sia-r14 on 5 of 1990 scanned pages (7 instances).

Steps to reproduce

Open https://www.medicare.gov/prescription-payment-plan.
Locate the element: <button class="video-embed-field-lazy-play" aria-label="Play video">
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

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-r1 WCAG 2.0 A Document has a title element (WCAG 2.4.2) 5/1990 pages · 5 instances

Bug ID: VS-35ddbdcd
Pattern ID: VS-0728f339
Combined ID: VS-35ddbdcd (pattern VS-0728f339) — use this format in JIRA/spreadsheets to filter by instance or pattern
WCAG category: WCAG 2.0 A
Obligation: required
Handling: review
WCAG SC: 2.4.2 Page Titled (Level A, WCAG 2.0)
Rule: Siteimprove Alfa — Document has a title element [sia-r1]
Example URL: https://www.medicare.gov/care-compare/resources/information-about-provider-types
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W32, last seen 2026-W36 (4 wk)

Description

Document has a title element. Detected by Siteimprove Alfa rule sia-r1 on 5 of 1990 scanned pages (5 instances).

Steps to reproduce

Open https://www.medicare.gov/care-compare/resources/information-about-provider-types.
Locate the element: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
Confirm the Siteimprove Alfa finding for rule sia-r1 against WCAG 2.4.2 Page Titled.

Impact

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

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

Affected pages

Testing environment

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

Suggested fix

See remediation guidance: https://alfa.siteimprove.com/rules/sia-r1

Triage status Notes

Minor axe empty-table-header Best Practice Table header text should not be empty (WCAG criterion undetermined) 3/1990 pages · 3 instances

Bug ID: VS-3a2f2791
Pattern ID: VS-d69fc059
Combined ID: VS-3a2f2791 (pattern VS-d69fc059) — 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 — Table header text should not be empty [empty-table-header]
Example URL: https://medicare.gov/account/login/help
XPath / selector: thead > tr > th:nth-child(1)
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

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

<th class="">&nbsp;</th>

Description

Table header text should not be empty. Detected by axe-core rule empty-table-header on 3 of 1990 scanned pages (3 instances).

Steps to reproduce

Open https://medicare.gov/account/login/help.
Locate the element: thead > tr > th:nth-child(1)
Confirm the axe-core finding for rule empty-table-header.

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/empty-table-header?application=axeAPI

Triage status Notes

Moderate alfa sia-r61 Undetermined Form field label is visible (WCAG criterion undetermined) 1/1990 pages · 1 instances Likely content

Bug ID: VS-19637f66
Pattern ID: VS-7118fead
Combined ID: VS-19637f66 (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://medicare.gov/publications/search/item/112376
XPath / selector: {"type":"document","children":[{"type":"type","name":"html","publicId":null,"sys
History: first seen 2026-W24, last seen 2026-W36 (13 wk)

Description

Form field label is visible. Detected by Siteimprove Alfa rule sia-r61 on 1 of 1990 scanned pages (1 instances).

Steps to reproduce

Open https://medicare.gov/publications/search/item/112376.
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

/publications/search/item/112376

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

Deque axe-core findings

Rule-level axe-core summary (7 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-W36, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
All page content should be contained by landmarks [region]	moderate	1690	3383	/publication-ordering/11377 /coverage/emergency-department-services /publication-ordering/02179	all 1690 pages (CSV)
Heading levels should only increase by one [heading-order]	moderate	40	40	/publications/search/all-non-english-pubs /publications/search/all-non-english-pubs /publications/search/all-non-english-pubs	all 40 pages (CSV)
Document should have one main landmark [landmark-one-main]	moderate	21	21	/care-compare/resources/nursing-home/care-compare/resources/nursing-home/quality-of-resident-care /my/medicare-complaint /care-compare/resources/nursing-home/staffing	all 21 pages (CSV)
Documents must have <title> element to aid in navigation [document-title]	serious	18	18	/care-compare/resources/nursing-home/care-compare/resources/nursing-home/quality-of-resident-care /care-compare/resources/nursing-home/staffing /care-compare/resources/care-compare/resources/information-for-providers	all 18 pages (CSV)
Frames must have an accessible name [frame-title]	serious	15	15	/publication-ordering/11377 /publication-ordering/12177-S /publication-ordering/11222	all 15 pages (CSV)
Page should contain a level-one heading [page-has-heading-one]	moderate	9	9	/publications/search/item/112371 /publications/search/item/112376 /health-drug-plans/medigap/ready-to-buy/spanish-medigap-open-enrollment	all 9 pages (CSV)
Table header text should not be empty [empty-table-header]	minor	3	3	/account/login/help /account/login/help /account/login/help	all 3 pages (CSV)

Siteimprove Alfa findings

Rule-level Alfa summary (12 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-W36, by pages affected
Rule	Impact	Pages affected	Instances	Example pages	All affected
Target size is at least 44×44 CSS pixels (Enhanced) [sia-r111]	n/a	523	17501	/publication-ordering/11377 /medical-equipment-suppliers/note-for-suppliers /prescription-payment-plan	all 523 pages (CSV)
Text has minimum contrast ratio of 4.5:1 [sia-r73]	n/a	519	5158	/publication-ordering/11377 /medical-equipment-suppliers/note-for-suppliers /prescription-payment-plan	all 519 pages (CSV)
Scrolling content can be accessed by keyboard [sia-r57]	n/a	487	3116	/publication-ordering/11377 /prescription-payment-plan /publication-ordering/11417	all 487 pages (CSV)
aria-hidden element does not contain focusable elements [sia-r17]	n/a	456	465	/publication-ordering/11377 /prescription-payment-plan /publication-ordering/11417	all 456 pages (CSV)
Text has enhanced contrast [sia-r66]	n/a	274	587	/coverage/alcohol-misuse-screenings-counseling /coverage/sleep-studies /coverage/chiropractic-services	all 274 pages (CSV)
Table header has scope [sia-r78]	n/a	143	183	/prescription-payment-plan /coverage/alcohol-misuse-screenings-counseling /health-apps/noom	all 143 pages (CSV)
First focusable element is link to main content [sia-r87]	n/a	15	15	/care-compare /care-compare /care-compare	all 15 pages (CSV)
Text has sufficient color contrast (Enhanced) [sia-r69]	n/a	9	47	/coverage/mental-health-substance-use-disorder /basics/get-started-with-medicare/medicare-basics/working-past-65 /providers-services/claims-appeals-complaints/appeals/drug-plans	all 9 pages (CSV)
Headings are structured hierarchically [sia-r53]	n/a	9	9	/publications/search/all-non-english-pubs /publications/search/all-non-english-pubs /publications/search/all-non-english-pubs	all 9 pages (CSV)
Accessible name of link or button matches visible label [sia-r14]	n/a	5	7	/prescription-payment-plan /basics/get-started-with-medicare /	all 5 pages (CSV)
Document has a title element [sia-r1]	n/a	5	5	/care-compare/resources/information-about-provider-types /care-compare/resources/information-for-providers /care-compare/resources/care-compare/resources/information-about-provider-types	all 5 pages (CSV)
Form field label is visible [sia-r61]	n/a	1	1	/publications/search/item/112376	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 (4242 raw engine findings → 4237 unique).

Unique issues (rule × page): 4237
Caught by both engines: 5 highest confidence
axe only: 1791
Alfa only: 2441

1 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-W36, by pages affected.
Issue	Pages	Rule references
Documents must have <title> element to aid in navigation	18	axe document-title · Alfa sia-r1 · ACT 2779a5