Still using it because of the massive amount of customizations accumulated in a time span close to yours. I'm often tempted to switch, but if I look back, what other editor would have served me for ~20 years, mostly unchanged? I remember writing lots of macros for Visual Studio 6 and then Microsoft revamped the object system of their IDE with .NET. My understanding is that Visual Studio plugins may not work from an IDE version to the next. Yes, customizing Emacs requires time, but so does relearning a new environment every few years.
I do use other editors, however, for things that would require too much time to configure in Emacs, or for which I prefer a GUI interface. For example, at the moment I'm working on a C++ project in Emacs, yet for debugging and a Git GUI I have VSCode open.
>> Is neovim better in this space?
Maybe, because of the bigger use base of NeoVim/Vim.
>> Should I be learning how to debug elisp better to understand how the commands interact with my environment?
Definitely.
>> I've been using emacs keybindings (in Dvorak at that)
Hi, mate! (^_^)
>> for so long I don't know if I'd enjoy the neovim editing experience.
What? No [Neo]Vim user has ever ported Emacs keybinding to Insert Mode? O_o