Photos by Jared Soares | The Roanoke Times

Barack Obama supporters cheer during his speech Thursday in Bristol. Some of the audience's biggest applause came in response to Obama's support for clean coal technology.

Democratic presidential candidate Barack Obama accepts a staff Thursday from Charles Edwards of Franklin County at Virginia High School in Bristol. The town hall-type meeting kicked off Obama's campaign for president in a state that hasn't backed a Democratic candidate since Lyndon Johnson in 1964.

Barack Obama (from left), Rep. Rick Boucher and former Gov. Mark Warner address the crowd at a rally in Bristol. Boucher said Obama's core issues — health care and economic development — focus on the concerns of the people of Virginia.

Ivy Foran, 7, of Bristol (left) and Queen Nagba, 3, of Johnson City, Tenn., draw while waiting in line Thursday to hear Barack Obama speak in Bristol. Much of Obama's speech focused on health care and soaring fuel prices.

Barack Obama attempts to catch a T-shirt thrown by a supporter after he spoke Thursday in Bristol. Obama said he chose Bristol because it represented the kind of people that Washington insiders no longer were listening to. Political analysts think Virginia could be a battleground state in the presidential election this fall.

BRISTOL -- Presumptive Democratic presidential nominee Barack Obama launched his general election campaign against Republican John McCain on Thursday, speaking to a crowd of fervent supporters in a congressional district that went heavily for his opponent in the primary and in a state that has since 1964 voted for Republicans.

But with fellow Democrats Mark Warner -- a U.S. Senate candidate and former governor -- and U.S. Rep. Rick Boucher nearby, Obama said there's a good reason he chose Bristol for his first public event since winning enough delegates to secure the Democratic nomination.

"Southwest Virginia is an example of so much that is good about this country, but so many people have been forgotten," Obama said. "There are good hardworking decent generous people in beautiful towns all throughout this region, but Washington hasn't been listening to you. It hasn't been paying attention to you. I'm here to let you know I'm going to be paying attention and I'm going to be listening."

Obama's presence seems to signal that Virginia, which has not supported a Democrat for president since Lyndon Johnson won it in 1964, is up for grabs this fall. Political analysts point to Warner and Tim Kaine's gubernatorial wins in 2001 and 2005 as evidence the state is trending blue, along with U.S. Sen. Jim Webb's upset win over George Allen in 2006.

Still, the state's rural areas lean toward Republicans, and that may have contributed to Obama's decision to start in Bristol before heading to Northern Virginia for an event later in the day. Speaking for nearly an hour, Obama focused largely on issues of health care, energy policy and the war in Iraq.

Obama touted a universal health care plan he said would provide insurance to the 47 million people who don't have it while lowering costs for those who do.

He said the plan would lower premiums by $2,500 per year, prevent exclusions for pre-existing conditions, provide government subsidies for those who can't afford insurance and emphasize prevention, regular checkups and physicals.

Obama said he would bring the various parties together to work out the plan's details and pledged to televise the negotiations so members of Congress could not back away from their promises to reform the system.

After he was presented with a maple walking stick by 95-year-old Charles Edwards of Union Hall, Obama brandished the gift and said it too may play a role in getting health care reform -- which he pledged to do by the end of his first term.

"If members of Congress don't pass my health care bill, I'm ready," Obama said to laughter from the crowd. "I'll whup 'em."

McCain's campaign released a statement noting that McCain supports a $5,000 per-family tax credit and greater affordability and accessibility to care. The statement also criticized Obama's plan as "unrealistic."

"Unlike Barack Obama, John McCain has the experience to understand that big government bureaucracy discourages competition, threatens our quality of health care and ensures the inefficiencies and frustrations Americans will not stand for," wrote McCain spokesman Tucker Bounds.

A sign reading "Affordable Health Care for All" adorned the podium from which Obama spoke before he moved out to take questions from the crowd. The first questioner was Victoria Cochran, a New River Valley lawyer and member of the state board of mental health, who asked about his plans to improve mental health coverage.

Obama used the question to draw parallels between the war in Iraq and mental health, citing post-traumatic stress disorder and other combat-related injuries as factors in the high number of suicides and homelessness among veterans.

"That is an outrage," Obama said before pledging that as president he'd ensure every discharged service member is screened and provided mental health services.

"We have to serve them as well as they served us," he said.

In response to a question about high gas prices, Obama similarly drew parallels between Iraq and national energy policy. He said he would work to lower gas taxes with a two-pronged strategy: a middle-class tax cut in the short term, and investing in alternative energy sources for the long term.

Obama said he'd push for increased fuel mileage standards and support more investment in solar, wind, biodiesel and clean coal technology.

The latter drew cries of support from a large contingent of the crowd representing the United Mine Workers of America. The UMWA endorsed Obama last month, and James Gibbs, the group's director of organizing, said the group's Castlewood office dispensed its entire set of tickets to the Bristol event in just over an hour.

But during a Wednesday conference call with reporters, Jerry Kilgore -- the former Virginia attorney general and 2005 GOP gubernatorial candidate who endorsed McCain in January -- questioned whether the union's workers would actually follow its endorsement.

Kilgore noted that in both of his state races he lost the UMWA endorsement, but still won Southwest Virginia.

"The union is not speaking for union members in those situations," Kilgore said.

Instead, he said, those members care about issues such as guns and taxes.

Kilgore attacked Obama's support for gun control and said he has an "F" rating from the National Rifle Association.

In response, Boucher said voters care about issues Obama is addressing, particularly health care, economic development and development of rural infrastructure such as broadband, water and sewer lines.

"That's what Americans care about," Boucher said. "Those are the issues that will drive the decision-making process."