In 1942, the Supreme Court upheld the arrest and conviction of a Jehovah's Witness who called a town marshall a "God damned racketeer" and a "damned fascist". The state law prohibited intentionally offensive speech directed at a third person in public. The opinion for a unanimous court stated that:
"There are certain well-defined and narrowly limited classes of speech, the prevention and punishment of which have never been thought to raise any constitutional problem. These include the lewd and obscene, the profane, the libelous, and the insulting or "fighting" words those which by their very utterance inflict injury or tend to incite an immediate breach of the peace. It has been well observed that such utterances are no essential part of any exposition of ideas, and are of such slight social value as a step to truth that any benefit that may be derived from them is clearly outweighed by the social interest in order and morality."
Over the next several decades, the SCOTUS ratcheted back this pretty broad statement and recognized a greater range of protected, but offensive speech. Thus, for example, flag burning has been found to be protected expression, even though it may be offensive to others. Most recently, while not a "fighting words" case, the court found that the Westboro Church's public "protests" at military funerals was protected speech even though it was outrageous and hurtful since the subject of the speech was on a public issue.
In short, while there is still a "fighting words" doctrine, exactly when it applies is not clear, although its clearly narrower than it was when the doctrine was created.
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