Effective March 23, 2010, authorizes section 1115 Medicaid waivers (as well as waivers under sections 1915(b) and 1915(c)) through which a state serves individuals who are dually eligible for Medicaid and Medicare to be carried out over a 5-year initial period. Upon Secretarial approval, waivers may be extended for additional 5-year periods. (Note that under pre-ACA law, section 1915(c) waivers were initially approved for a 3-year period with the ability to be renewed for up to 5 year periods. Section 1915(b) waivers were initially approved for 2 years and renewed for up to 2-year periods. Section 1115 demonstrations were initially approved for a period of 5 years and extended for a period of up to 3 years).