One can re-align when accessing; this is how SBCL e.g. handles tagging. e.g. the first slot would be accessed by MOV RAX, [RBX - 1].
In SBCL, this also allows cons cells to have their own offset, so car and cdr are implemented with one instruction and are safe (that is, throw an exception if applied to something they don't work on) even in code compiled at (safety 0).
Now just waiting for parallel GC in SBCL. ;) Well, also waiting for some other things, I will admit.
It is? By default x86 will happily do unaligned accesses, and I'm pretty sure SBCL doesn't change that. Not sure about other instruction sets.
SBCL also uses double-word alignment and 4-bit tags, so you could CDR (expecting lowtag #b0111) a structure object (lowtag #b1111).