For many citizens, public services are the most direct and tangible output of the democratic process, and yet in the past thirty years policymakers have privatized a broad swath of these services. This article asks whether privatization of state services changes citizens’ willingness to use the ballot box to hold governments to account for service performance. It argues that citizens can hold governments to account for privatization, but only if they have genuine political alternatives. Where quality falls with privatization and citizens can vote for an anti-privatization party, what we call a clear signal, privatization can mobilize citizens to sanction incumbents. By contrast, where quality falls but there are few anti-privatization alternatives, a mixed signal, privatization reduces sanctioning behavior. To test this theory, the article draws on a panel difference-in-differences analysis of disability reform from the United Kingdom, leveraging a geographically varied introduction of private provision across two political contexts.