I don't really use reddit a ton anymore but tbh I don't think I'll be staying here either.
I hated the reddit redesign on desktop because it did some annoying things like waste a ton of space, and sadly Lemmy on desktop has similar usability issues to new.reddit in that regard. I could fix it with userstyles (like I could new reddit), but I'd much rather not have to. These are things that can be fixed dev-side too, but until that happens I really just don't like using the default lemmy experience.
Also I use iOS and the iOS app selection for Lemmy is severely lacking, the app that does exist (Mlem) does not have great usability imo
Okay some notes to add:
The accessibility focused third party apps (Dystopia for iOS, Redreader for Android, there might be more) were granted exemptions to the API pricing, so they can continue to operate after the changes. Dystopia will also soon be available on the iOS App Store (as opposed to having to use Testflight) so as a silver lining it'll be easier to access for users who need it, while Redreader is considering implementing Lemmy support.
Bots are in a weird place because most likely don't exceed the API usage rates for the free tier - RemindMe Bot for example has explicitly stated it isn't going to die with the changes, and that its usage is well under the free tier. I imagine smaller community-specific ones (like the wf subreddit ones) will similarly be far below the free tier limits.
For desktop, the mod tools extension (Toolbox) will remain in their current state, and RES expects to as well. Both projects have dwindling interest in continued development aside from basic maintenance though, certainly not helped by reddit's increased hostility to developers. Newer reddit features also aren't exposed to the api so Toolbox can't integrate them them either.
tl;dr: Some small progress in accessibility concerns, not really enough. Reddit doesn't deserve a medal for doing the bare minimum in not completely rejecting every blind user from using their service, though noting what they're doing on that front (good and bad) still matters.