I gave it a quick try! Very nice game! Mechanics are simple and enjoyable. And it's great to see an accessible roguelike! Would love to see this concept fleshed out.
One thing I picked up is that the card description for silver says it's worth 5 copper, but the screenreader just says it can be traded for goods and services. Might want to add the 5 copper to the read description.
Other than that, it seems to work great with NVDA. I've sent it to some blind friends of mine to try out, and I'll let you know if they have any comments.
Also, as a programmer and amateur game creator myself, I'd love to see how things are implemented. Do you have some source code available somewhere? Are you perhaps accepting pull requests? Is there an offline-playable version available?
Once again, thanks, this is very cool!