In the deeply divided US, it is difficult to predict the outcome of next month's midterm elections

Months of feuding have not helped the Democrats but Trump is weak on bread-and-butter issues like healthcare and the mood is febrile

A record number of native American women are running in the US midterms, including Deb Haaland, one of three female candidates running in New Mexico and Kansas. Mark Ralston / AFP

Sandwiched between a tweet about immigration and another looking forward to an election rally in Montana, US President Donald Trump opined about healthcare.

The president chose his favourite method of communication to tell voters: “All Republicans support people with pre-existing conditions, and if they don’t, they will after I speak to them.”

His decision to mention healthcare is intriguing, given that it is hardly favourable territory for the GOP.

It is an odd move, given how he had capitalised on the bitter row over the appointment of Brett Kavanaugh to the Supreme Court, with Republican senators coming out fiercely in support of the judge and enabling the GOP to make massive in-roads into what had been a healthy Democratic lead ahead of next month's midterm elections.

But, not for the first time, there is a chance that Mr Trump might be ahead of the electoral curve.

There is little doubt that the Kavanaugh controversy stirred up the president’s conservative base but the dust seems to be settling – and that could be a cause for Republican concern.

While the direction of traffic in the polls is still promising for the GOP, the pace has slowed. In a key race, the battle for one of Tennessee's Senate seats, it appears to have reversed.

The danger for the GOP is that the peak Kavanaugh frenzy has passed and by the time voters head to the polls, bread-and-butter issues like healthcare will have moved back up the agenda.

That is good news for the Democrats. The party has been hammering away on the issue. According to the Wesleyan Media Project, 44 per cent of its campaign ads have been devoted to healthcare.

It is an issue – along with a visceral loathing of Mr Trump – guaranteed to fire up Democratic voters and get them to the polls in the sort of numbers they need to deliver the “blue wave” they have been hoping for.

So rather shrewdly, Mr Trump has been protecting his most vulnerable flank, not only by promising that Americans will be able to get insurance even if they have a pre-existing condition but also moving against drug companies.

He has proposed they should be compelled to disclose the cost of drugs they advertise on television.

Of course, the president’s attack strategy remains in place as he charges around the country, addressing several rallies a week.

As the Kavanaugh row dies down, Mr Trump has found little difficulty in finding other issues to rile his supporters.

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Vast crowds have lapped up his attacks on the Democrats, the media and anybody who has aroused his ire, such as Elizabeth Warren, seen by many as a likely opponent in the 2020 presidential election.

At rally after rally, he has fed them electoral red meat, accusing the Democrats of encouraging mob rule and heaping praise on Greg Gianforte, the Montana congressman who body-slammed a Guardian reporter. Mr Trump is telling Republicans to get out and vote as if he were on the ticket.

So where does this leave the Democrats? A few weeks ago, the expectation was not only of the party taking control of the House of Representatives but possibly "flipping" the Senate as well.

Such extravagant talk seems to have died down and some are predicting that while the Democrats are still on course to take the House, the Republicans could strengthen their grip on the Senate.

Democratic senators Claire McCaskill in Missouri and Heidi Heitkamp in North Dakota are seen as particularly vulnerable. West Virginia’s Joe Manchin, who broke ranks and backed Mr Kavanaugh’s nomination, appears to be safe for the time being.

One of the party’s biggest problems is that the economy is actually booming. The recovery might have started well before Mr Trump took office but he is claiming credit for the lowest unemployment figures in decades.

The Democrats have also not been helped by months of feuding between the party establishment and the radical wing, which is still nursing a grudge at the way in which Bernie Sanders was treated two years ago.

There have been attempts to heal the rift. Mr Sanders and Tom Perez, the DNC chair, went on a nationwide speaking tour in the aftermath of the presidential election defeat.

Some traditionally establishment figures have been making radical noises. Eric Holder, the attorney general in the Obama administration and another possible 2020 candidate, said it was time to get tough with the Republicans.

“When they go low, we kick them,” he said and dismissed accusations that he was encouraging mob violence as “fake outrage”.

The party’s radical wing has won some notable victories in the primaries, notably that of Alexandria Ocasio-Cortez in New York, who unseated Joe Crowley, the Democratic Caucus chair.

Nearly 200 women have been nominated by the Democrats to run for the House of Representatives or Senate. In the age of the #MeToo movement, the party hopes that this brings out female voters - who are more inclined to dislike Mr Trump – in vast numbers.

Given the febrile mood of the electorate, it is difficult to predict what will happen in a country which is deeply divided.

Even by American standards, campaign ads have been particularly vicious. Several contests have been mired in allegations of dirty tricks, gerrymandering and voter suppression.

If Mr Trump succeeds in retaining control of both houses, many think there will be further changes in his administration as he forges ahead with his agenda.

There are already suggestions that Jim Mattis, the respected Secretary of Defence, is on borrowed time.

However, if the Democrats gain control of either the House of Representatives or the Senate, the US could be moving into interesting territory.

While Mr Trump would almost certainly survive any attempt to impeach him, he would face administrative gridlock.

The past two years would seem like plain sailing compared to the second half of Mr Trump’s term, especially if the Democrats' radical wing asserts itself on Capitol Hill.

Mr Trump would be left as a lame duck president – in office, but not in power.

David Millward is a journalist based in the US