Imagine how long it would take to load a page of HN search results, or the table of contents of an online book, or a page with a lot of dead links, or a page with links to a whole bunch of non-textual content that it has to figure out is non-textual.
While that would work in many situations, I think the number of edge cases would be too great to make it reliable as a primary mode for communicating meaning in an accessible interface. As an alternative assistive feature? Sure. Something to rely on? I'll believe it when I hear it.
Yes, or it can summarize the text and explain what the link is to.