We argue that economic inequality harms social provisions for the poor, but that higher political competition can mitigate this effect. We test this hypothesis using a large redistricting of electoral boundaries in India and find that higher inequality causes more post-neonatal infant deaths, but only when there is weak political competition. We further show that government health centers located in constituencies with low political competition and high inequality are disfavored, indicating that the effect on mortality operates via changes in public provision. Finally, we show that the same mechanisms are at play in the implementation of the MGNREGA employment program.