(in absence of any U.S. Supreme Court precedent supporting it's reasoning, court holds that health insurance mandate included in Patient Protection and Affordable Care Act is legitimate exercise of Congress' power under Commerce Clause because court determined that choosing not to purchase health insurance is an "economic activity"; court argues that "health care is special" by defining relevant market as health care rather than health insurance; no explanation given as to constitutional relevance of health care providers being required to provide emergency health care; mandate provision upheld under Necessary and Proper Clause with no explanation of why the arguments against the mandate are wrong; court did not address how mandate either violates or does not violate five factor test set forth in United States v. Comstock; court did find that mandate is a "penalty" and not a "tax" and, thus, cannot be upheld under Congress' power to tax).