On his final stop of a three-state tour hours before voting opens, the president chose pantomime over policy

Even the protesters could agree with Donald Trump on this one point before they were dragged out to another chorus of booing.

“Is there anything like a Trump rally?” the president asked the whooping crowds as he stumped across three states in a last push to win votes in Tuesday’s midterm elections.

The cheers went up, and then the chants of “USA”.

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Trump was right. There really has never been anything like his rallies in modern American politics. Even with the future of his presidency at stake in Tuesday’s vote, he chose pantomime over policies. And it worked, at least for the length of the show.

Trump told the crowds his presidency was going so well that by the time he comes up for reelection in 2020 his Make America Great Again slogan will be out of date because America will already be great.

“Our new slogan in another year will be Keep America Great,” he said.

They loved that. But before the new hats get made, the president has to get through the midterms.

Trump faces the prospect of losing control of the House of Representatives and with it the hope of fulfilling his promise of more tax cuts and the dismantling of President Obama’s health care reforms.

The Republicans look better positioned to hold onto the Senate, and if that happens Trump is sure to declare it a victory. But the loss of the House would be widely seen as a popular judgement on his presidency. It also opens the door to Congressional investigations into the actions of Trump and his associates in and out of office, including alleged collusion with Russia during the 2016 presidential election.

There was little sense of the potential danger at the president’s final rally of the campaign in Cape Girardeau, a small city in southeastern Missouri on the Mississippi river, as he weaved between the indiscriminate ramblings that make him and the crowd most happy, and occasional focus on the issues which have defined the campaign.

Facebook Twitter Pinterest Supporters cheers as US President Donald Trump arrives at a Make America Great Again rally in Cape Girardeau, Missouri Photograph: Jim Watson/AFP/Getty Images

The crowd, surprisingly jolly for people who claim to be so angry, played its part, swinging between hearty cheers as the president proclaimed himself at the head of the “single greatest political movement in the history of our country” and boisterous booing at the names of the leading Democratic villains. Trump played the persecuted president and the genius president, and the crowd played along.

At one point the president bizarrely told his audience that in an age of elites they are the “super-elite”. They weren’t quite sure what he meant.

“We are the voice for every citizen who has ever been overlooked, neglected, ignored,” he proclaimed.

That is a claim that has been increasingly challenged through the midterms and put some Republicans on the back foot.

One of the most effective political weapons used by the Democrats during the campaign has been a focus on fears about access to affordable healthcare, particularly if the Republicans scrap Obamacare. Voters from both parties list it among their leading concerns, particularly a clause in the existing law that protects health insurance companies from discriminating against people with pre-existing conditions that are likely to require expensive treatment, such as cancer. Before Barack Obama’s reforms, insurance firms were also able to cut people off mid-treatment.

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It was an issue Trump could not sidestep. Instead, the president accused the Democrats of planning a “socialist takeover” of healthcare.

“The Democrat plan will obliterate Obamacare, which is good, but leave the bad parts,” he said.

Trump promised that he too will obliterate Obamacare but still protect the interests of patients.

“The Republicans will always protect people with pre-existing conditions,” he promised the crowd with a notable lack of specifics for how, or his broader plans for an alternative to the existing law.

The cheers were there, but not with quite the same energy.

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Trump paraded some of his more prominent supporters on stage without allowing them too much of the limelight. The Fox News presenter and conspiracy theorist Sean Hannity fleetingly appeared as did the right wing radio host, Rush Limbaugh, who frightened the crowd by threatening to talk for half an hour but kept it to a few minutes. There were enthusiastic receptions for Kellyanne Conway and Sarah Huckabee Sanders from the White House staff.

Earlier in the day, Trump conceded to ABC News that he may have made a single mistake during his presidency.

“I would like to have a much softer tone. I feel, to a certain extent, I have no choice. But maybe I do. And maybe I could’ve been softer from that standpoint,” he said.

But if the president believed that, it wasn’t on show in Missouri. Trump accused the Democrats of the politics of division and destruction, and called on voters to get behind his “righteous” cause.

“Democrats produce mobs. Republicans produce jobs,” he mocked.

He pushed all the buttons with his routine on immigrants and crime, warnings of an “invasion” by a caravan of “Democrat-sponsored migrants” approaching the southern border, and of the supposed threat posed by “leftwing mobs”.

“If you want more caravans and more crime, vote Democrat,” he taunted.

The crowd enjoyed that much more than Trump talking about the US moving its embassy in Israel to Jerusalem or walking away from the Iran nuclear deal. So did the president. Whether he will find Tuesday evening as agreeable, once the rest of America has had its say, remains to be seen.