In the hot skillet, add the onions to the pan (with drippings and butter). Sautee over medium heat until softened.
Add minced garlic and sautee until fragrant, 1-2 minutes.
Add tomato paste and stir until onions and garlic are well coated and red.
Add tomato sauce, water, spices, apple cider vinegar and worchestershire to the mixture and gently whisk until well combined.
Bring to a boil. Taste for salt and adjust if necessary.
Remove from the heat, and add the meatballs back to the pan.
Place skillet in the oven for 20 minutes or until meatballs are cooked through and sauce is bubbling.
Remove from oven, serve over spaghetti, with cheddar, onions, beans - however you enjoy your cincy chili!