If the assistive technology they need to use isn't available on Linux or they don't have the ability to run Linux it's not that meaningful of a difference.
And rather sad that free software - which in theory ought to be a perfect place for exploring assistive options - seems to lag far behind the closed shops.
Having discussed this with Drew, I think he was really talking about what I, personally, should choose to work on. And I think he's right that I should work on the accessibility of free software as much as I can, rather than accessibility on proprietary platforms. I don't know yet how soon I can actually start doing this.