Matthew Gertz expands on the subject at Media Matters:

It is nonetheless revealing that it was Trump who awarded Limbaugh the medal. You can draw a straight line between Limbaugh’s rise to prominence and his acceptance by the Republican establishment and the president’s own conquest of the party.

Limbaugh has had a virtually unmatched influence on Republican politics for the last 30 years, rising from obscurity to become a kingmaker who described himself as “the titular head” of the GOP. Speaking daily to an audience which grew to tens of millions, he converted listeners, often working-class whites who in the past might have been Democratic voters, into loyal “dittoheads” who spouted the platitudes of conservatism and supported Republicans. Party leaders — from the previous three GOP presidents on down — learned to praise and cater to him, while those who crossed him quickly reversed themselves.

…

Limbaugh’s career shows that by relying on a toxic slurry of bigotry, conspiracy theories, smears, and right-wing talking points, you can win a massive audience of devoted fans who will shower you with lucre and hang on your every word. And it demonstrates that once you achieve a certain trajectory in conservative politics, you become effectively inured to the costs that disgusting remarks might otherwise bring. Once that standard was set in right-wing media, it was only a matter of time before a political entrepreneur tested the same mix in a national political context.

In other words Trump is just Limbaugh but stupider. I wonder if Limbaugh is kicking himself for not doing it instead of Trump.