By the way, is it worth the effort
nowadays?
Yes, it's worth worrying about accessibility. You should use progressive enhancement where possible, i.e. make a basic version that works without scripting and then add the scripting functionality on top of it.
A simple example would be a pop-up link. You could make one like this:
<a href="javascript:window.open('http://example.com/');">link</a>
However, this link wouldn't work if someone, say, middle-clicked or tried to bookmark it, or had scripts disabled etc. Instead, you could do the same thing like this:
<a href="http://example.com/"
onclick="window.open(this.href); return false;">link</a>
It's still not perfect, because you should separate the behavior and structure layers and avoid inline event handlers, but it's better, because it's more accessible and doesn't require scripting.