This study examines the impact of mayor-council coalitions on local government spending, service delivery, and corruption in Indonesia. The investigation finds that majority coalitions, i.e. those coalitions for which participating political parties control greater than half of council seats, cause a shift in local government spending towards health sector activities and induce improvements in citizen health service access—but only during the first year or two, after which the positive effects disappear. On the other hand, the study shows that corruption starts to become problematic in the last two years of the coalition’s life. Majority coalition support for the local health spending and service agenda dissipates quickly, therefore, as attention turns to corrupting the budget. It is hypothesized that budget fraud serves, in part, to finance subsequent rounds of local parliamentary and executive elections.