The Center to Protect Patient Rights was created in April 2009, just as the debate over the healthcare bill was heating up. The group's mission was to "protect the rights of patients to choose and use medical care providers," according to its corporate paperwork, filed in Maryland.
While never surfacing publicly, the center sent more than $10 million in its first year to groups such as Americans for Prosperity, which took a lead in protesting the measure.
"I think they saw what we were doing and liked it," said Tim Phillips, president of Americans for Prosperity, which got $4.1 million. He said he did not know the source of the center's funding and declined to comment on whether it still supports his group.
The center's influence extended beyond the healthcare debate, tax filings show. Money also went to antiabortion groups such as the Susan B. Anthony List and to Americans for Tax Reform, led by Grover Norquist. In Florida, the center backed Protect Your Vote, a Republican effort to defeat two redistricting measures.
The largest share of the center's money went to American Future Fund, a Des Moines-based group started by onetime GOP congressional aide Nick Ryan. The fund, which ran campaigns against two dozen Democrats in the 2010 election cycle, spent $23 million that period, tax filings show, with nearly $13 million coming from the center.
Its biggest target was an up-and-coming Iowa Democrat, Rep. Bruce Braley. In August 2010, American Future Fund launched an ad falsely claiming that Braley supported building a mosque at the former World Trade Center site in New York — the beginning of a $2-million fusillade that included radio ads, robo-calls and nine mailers.
"It was almost a feeling of helplessness because there was no way to identify who the source of the funds was," Braley said.
After winning his 2008 race by 29 percentage points, Braley squeaked to a 2-percentage-point victory.
Knowing now who helped finance the attacks is small consolation, he said. "It does nothing to shed light on who is contributing the hundreds of millions now that is being wound up to be used in races like mine again," he said.
Ryan did not respond to requests for comment.
The center appears closely linked with DCI Group, a Washington-based consulting firm that specializes in under-the-radar corporate campaigns.
At least five groups that received large grants from the center paid more than $9 million in services to DCI Group or Direct Response, a mail and phone-bank company. The two companies share a suite in a Phoenix office building, but a spokesman said they were no longer legally affiliated.
For example, the center gave more than $2 million to the similarly named Coalition to Protect Patients' Rights, a Virginia-based nonprofit formed in spring 2009, five weeks after the center. The two organizations share the same Phoenix accountant and records custodian — both former DCI employees, according to their online resumes.
The coalition staged rallies in 2009 to lobby against the so-called public option, a government medical insurance proposal eventually dropped by the Obama administration. The center provided 80% of the coalition's budget; nearly all went to DCI and Direct Response for consulting and voter contact.
DCI Group spokesman Craig Stevens said the firm did not set up the center or know where the coalition got its money.
New Orleans surgeon Donald Palmisano, former president of the American Medical Assn.and the public face of the coalition, also said he did not know the source of funding.
"I'm just the spokesperson," Palmisano said.
Special correspondent Matthew Trotter in Phoenix contributed to this report.