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It definitely works, but is a bit extra challenging to manage food before that. The good thing is that caves have their own microclimate, so most of the time it has perfect living temperature, so air conditioning isn't really needed.
Soon there will also be mod-addons that give more alternatives. One is an integration of the Biomes! mods, so you can get all the stuff from Biomes! Caves to make life easier.
Another is a mod I'm working on for more diverse power generation and especially something to improve the cave start. I can't say when the second will be done, but the Biomes! integration comes with the next big patch on their side.
People can obviously play like they want, although I would recomment to try the additional challenge the biomes gives first, before modding everything back to normal.