The current state of accessibility and interoperability varies greatly from vendor to vendor and state to state. While a number of states and vendors have embraced QTI for interoperability and accessibility, only a fraction of the formative and interim tests that are administered each year support QTI for interoperability and accessibility. What's more, district-level assessments and testing platforms are far less likely to have the accessibility features needed to test all students online. How do we overcome these obstacles and improve the testing experience for all students?