We present an improved determination of the Hubble constant (H0) from Hubble Space Telescope (HST) observations of 70 long-period Cepheids in the Large Magellanic Cloud. These were obtained with the same WFC3 photometric system used to measure Cepheids in the hosts of Type Ia supernovae. Gyroscopic control of HST was employed to reduce overheads while collecting a large sample of widely-separated Cepheids. The Cepheid Period-Luminosity relation provides a zeropoint-free link with 0.4% precision between the new 1.2% geometric distance to the LMC from Detached Eclipsing Binaries (DEBs) measured by Pietrzynski et al (2019) and the luminosity of SNe Ia. Measurements and analysis of the LMC Cepheids were completed prior to knowledge of the new LMC distance. Combined with a refined calibration of the count-rate linearity of WFC3-IR with 0.1% precision (Riess et al 2019), these three improved elements together reduce the full uncertainty in the LMC geometric calibration of the Cepheid distance ladder from 2.5% to 1.3%. Using only the LMC DEBs to calibrate the ladder we find H0=74.22 +/- 1.82 km/s/Mpc including systematic uncertainties, 3% higher than before for this particular anchor. Combining the LMC DEBs, masers in NGC 4258 and Milky Way parallaxes yields our best estimate: H0 = 74.03 +/- 1.42 km/s/Mpc, including systematics, an uncertainty of 1.91%---15% lower than our best previous result. Removing any one of these anchors changes H0 by < 0.7%. The difference between H0 measured locally and the value inferred from Planck CMB+LCDM is 6.6+/-1.5 km/s/Mpc or 4.4 sigma (P=99.999% for Gaussian errors) in significance, raising the discrepancy beyond a plausible level of chance. We summarize independent tests which show this discrepancy is not readily attributable to an error in any one source or measurement, increasing the odds that it results from a cosmological feature beyond LambdaCDM.
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