Is it only expiation (kaffarah) that is obligatory, or expiation along with making up the fast (qada'), for a chronically ill person who broke their fast in Ramadan due to their inability to fast, and later attempted to make it up but failed?

Fasting for missed Ramadan days due to illness must be made up as long as it is possible, based on the Almighty's saying: "So whoever among you is ill or on a journey [during them] - then [he must make up] an equal number of other days." The fidyah (expiatory feeding) does not substitute for making up the fast unless one is completely incapable, with no hope of recovery. If the making up of the fast is delayed until the next Ramadan intentionally, with knowledge of its impermissibility, then a fidyah is required for each day. However, if it was due to forgetfulness, incapacity, or ignorance of its impermissibility, then only making up the fast is required.