This bill reauthorizes and expands the Southwest Border Regional Commission, a federal agency that provides development assistance to Arizona, California, New Mexico, and Texas. The bill increases funding from the current level to $100 million annually through 2028, then $200 million annually from 2029 to 2033. It also adds several new grant programs focused on workforce development and capacity building in border counties, including $10 million annually for state capacity building grants to support business retention, job creation, broadband expansion, and training centers in universities within distressed areas. The legislation creates new authority for the commission to provide grants for health care facilities and services addressing healthcare workforce shortages, as well as water and wastewater infrastructure projects. Additionally, the bill waives matching fund requirements for colonias (low-income border communities) and Indian tribes receiving assistance, allowing them to access federal funding without contributing local resources.